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Etinger R, Comaneshter D, Amital H, Cohen AD, Tiosano S. The long-term prognostic significance of heart failure in sarcoidosis patients ─ a cohort study. Postgrad Med 2020; 133:202-208. [PMID: 33019840 DOI: 10.1080/00325481.2020.1832773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the proportion and the long-term prognostic significance of heart failure (HF) in sarcoidosis patients. METHODS Data extracted from a large Israeli healthcare provider's database were used to study sarcoidosis patients and matched non-sarcoidosis controls since 2000 to 2016. The proportion of HF was compared between the groups, and the associations between sarcoidosis, HF, and all-cause mortality were assessed. RESULTS Included were 3,993 sarcoidosis patients and 19,856 age- and sex-matched controls. The proportion of HF patients was higher among the former (10.9% and 5.3%, respectively). A logistic regression model for multivariable analysis for covariates found sarcoidosis to be independently associated with HF (Odds Ratio (OR) 2.09 confidence interval (CI) 1.83-2.39). A total of 710 sarcoidosis patients (17.8%) and 2,121 controls (10.7%) died during the study period (p < 0.001). A multivariable survival analysis found an estimated hazard ratio (HR) of 1.84 (95%CI 1.67-2.02), indicating a significant association between sarcoidosis and risk for all-cause mortality. Our analysis also revealed a significant association between HF and risk for all-cause mortality (HR 3.05, 95%CI 2.77-3.36). CONCLUSIONS Sarcoidosis is independently associated with HF, and both are independently associated with all-cause mortality.
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Affiliation(s)
- Roie Etinger
- Faculty of Medicine, Tel Aviv University Sackler, Tel Aviv, Israel
| | - Doron Comaneshter
- Department of Quality Measurements and Research, Clalit Health Services, Tel-Aviv, Israel
| | - Howard Amital
- Faculty of Medicine, Tel Aviv University Sackler, Tel Aviv, Israel.,Department of Internal Medicine B and Research Center for Autoimmune Diseases, The Chaim Sheba Medical Center at Tel Ha Shomer, Ramat-Gan, Israel
| | - Arnon D Cohen
- Department of Quality Measurements and Research, Clalit Health Services, Tel-Aviv, Israel.,Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer Sheva, Southern Israel
| | - Shmuel Tiosano
- Faculty of Medicine, Tel Aviv University Sackler, Tel Aviv, Israel.,The Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Israel
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Alnaimat F, Al Oweidat K, Alrwashdeh A, Alnashrati A, Barham S, Hijaz M, Murad D, Alshelleh S, Obeidat N. Sarcoidosis in Jordan: A Study of the Clinical Phenotype and Disease Outcome. Arch Rheumatol 2020; 35:226-238. [PMID: 32851372 PMCID: PMC7406155 DOI: 10.46497/archrheumatol.2020.7584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 07/16/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study aims to evaluate the clinical phenotypic features of sarcoidosis in a single-center academic hospital in Jordan. PATIENTS AND METHODS A retrospective file review was performed at an academic medical center in Jordan that included all patients diagnosed with sarcoidosis between January 2000 and December 2018. A total of 150 patients with sarcoidosis (38 males, 112 females; mean age 47.8±11.7 years; range, 17 to 79 years) were evaluated. Clinical data extracted from the files included the sex of the patient, the age at time of diagnosis, diagnosis date, the season during which the diagnosis was established, and smoking history. Biopsy histopathology, spirometry, nerve conduction, echocardiography, and imaging reports including plain radiographs, ultrasonographic, magnetic resonance and computed tomography reports were reviewed. Data including laboratory values, medication usage, clinical outcomes, and morbidity/mortality were collected. Pulmonary function tests including spirometry and lung volumes along with the diffusing capacity for carbon monoxide were reviewed for the presence of restriction, obstruction or reduction in the diffusion capacity of carbon monoxide. Identification of extra-thoracic organ involvement was determined in each patient in accordance with the criteria suggested by the updated World Association of Sarcoidosis and Other Granulomatous Disorders. RESULTS A total of 77.3% of the patients were diagnosed by biopsy. One case of Lofgren's syndrome was identified. Of the patients, 18.0% had isolated pulmonary sarcoidosis, 75.3% had pulmonary and extra-pulmonary sarcoidosis and 6.7% had isolated extra-pulmonary sarcoidosis while 81.3% had respiratory symptoms, mostly shortness of breath and cough. Extra-thoracic organ involvement mostly involved the musculoskeletal system (33%) followed by the skin (20%). Female patients had more extra-thoracic involvement but the sex difference was only statistically significant for cutaneous involvement. Of the patients, 84% received treatment while 20% had disease remission during the first two years after diagnosis and 70% required treatment beyond two years after diagnosis. CONCLUSION Various sarcoidosis clinical phenotypes are seen among Jordanian patients. Jordanian females are more affected by the disease and have more extra-thoracic involvement compared to male patients. A large number of the study patients received treatment.
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Affiliation(s)
- Fatima Alnaimat
- Department of Internal Medicine, Division of Rheumatology, University of Jordan, Amman, Jordan
| | - Khaled Al Oweidat
- Department of Internal Medicine, Division of Respiratory and Sleep Medicine, University of Jordan, Amman, Jordan
| | - Anas Alrwashdeh
- Department of Internal Medicine, University of Jordan, Amman, Jordan
| | - Ahmad Alnashrati
- Department of Internal Medicine, University of Jordan, Amman, Jordan
| | - Saba Barham
- Department of Internal Medicine, University of Jordan, Amman, Jordan
| | - Mohammad Hijaz
- Department of Internal Medicine, University of Jordan, Amman, Jordan
| | - Dina Murad
- Department of Internal Medicine, University of Jordan, Amman, Jordan
| | - Sameeha Alshelleh
- Department of Internal Medicine Division of Nephrology, University of Jordan, Amman, Jordan
| | - Nathir Obeidat
- Department of Internal Medicine, Division of Respiratory and Sleep Medicine, University of Jordan, Amman, Jordan
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Jeon MH, Kang T, Yoo SH, Swan HS, Kim HJ, Ahn HS. The incidence, comorbidity and mortality of sarcoidosis in Korea, 2008-2015: a nationwide population-based study. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2020; 37:24-26. [PMID: 33093766 PMCID: PMC7569540 DOI: 10.36141/svdld.v37i1.7660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/10/2020] [Indexed: 01/13/2023]
Abstract
Background: Few national level, population-based studies are present on the epidemiology of sarcoidosis and it is unclear whether these patients have higher mortality than the general population. The objective of this study was to investigate the nationwide epidemiology, comorbidity and mortality in sarcoidosis in Korea. Material and Methods: For the period between 2008 to 2015, we used the national population-based database operated by Rare Intractable Disease registration program in which patients’ diagnosis are based on uniform criteria. All sarcoidosis patients were identified and followed-up using the National Health Insurance database to determine their incidence, comorbidity, mortality, causes of death and standardised mortality ratio (SMR). Results: During the study period, we identified 3,259 new sarcoidosis patients. The average annual incidence was 0.81 per 100,000. The annual mortality rate was 9.26 per 1,000 person-years. The mortality rate were significantly higher than those of the general population (SMR 1.91, 95% confidence interval 1.62-2.25). The major comorbidities of sarcoidosis patients were the diseases of the respiratory system (17.64%), heart (5.43%), eyes (4.27%) and cancer (2.3%). Mortality was higher in patients with lung involvement. Of the 84 deaths identified in this study from 2008-2013, the most common cause of death was cancer (41.7%), followed by respiratory disease (13.1%), sarcoidosis (13.1%) and heart disease (8.3%). Conclusions: We reported a nationwide incidence of sarcoidosis as 0.81 per 100,000 in Korea. The mortality of sarcoidosis patients was higher compared to the general population and the major causes of death were cancer, respiratory disease and sarcoidosis. Sarcoidosis patients with comorbid diseases showed increased mortality. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (1): 24-36)
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Affiliation(s)
- Mi Hye Jeon
- Department of Public Health, Graduate School, Korea University
| | - Taeuk Kang
- Department of Public Health, Graduate School, Korea University
| | - Sang Hoon Yoo
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, Daejeon St.Mary's Hospital, The Catholic University of Korea
| | - Heather S Swan
- School of Sociology and Anthropology, University of Ottawa
| | - Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, College of Medicine, Korea University
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4
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Schupp JC, Freitag-Wolf S, Bargagli E, Mihailović-Vučinić V, Rottoli P, Grubanovic A, Müller A, Jochens A, Tittmann L, Schnerch J, Olivieri C, Fischer A, Jovanovic D, Filipovic S, Videnovic-Ivanovic J, Bresser P, Jonkers R, O'Reilly K, Ho LP, Gaede KI, Zabel P, Dubaniewicz A, Marshall B, Kieszko R, Milanowski J, Günther A, Weihrich A, Petrek M, Kolek V, Keane MP, O'Beirne S, Donnelly S, Haraldsdottir SO, Jorundsdottir KB, Costabel U, Bonella F, Wallaert B, Grah C, Peroš-Golubičić T, Luisetti M, Kadija Z, Pabst S, Grohé C, Strausz J, Vašáková M, Sterclova M, Millar A, Homolka J, Slováková A, Kendrick Y, Crawshaw A, Wuyts W, Spencer L, Pfeifer M, Valeyre D, Poletti V, Wirtz H, Prasse A, Schreiber S, Krawczak M, Müller-Quernheim J. Phenotypes of organ involvement in sarcoidosis. Eur Respir J 2018; 51:51/1/1700991. [PMID: 29371378 DOI: 10.1183/13993003.00991-2017] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 10/25/2017] [Indexed: 01/08/2023]
Abstract
Sarcoidosis is a highly variable, systemic granulomatous disease of hitherto unknown aetiology. The GenPhenReSa (Genotype-Phenotype Relationship in Sarcoidosis) project represents a European multicentre study to investigate the influence of genotype on disease phenotypes in sarcoidosis.The baseline phenotype module of GenPhenReSa comprised 2163 Caucasian patients with sarcoidosis who were phenotyped at 31 study centres according to a standardised protocol.From this module, we found that patients with acute onset were mainly female, young and of Scadding type I or II. Female patients showed a significantly higher frequency of eye and skin involvement, and complained more of fatigue. Based on multidimensional correspondence analysis and subsequent cluster analysis, patients could be clearly stratified into five distinct, yet undescribed, subgroups according to predominant organ involvement: 1) abdominal organ involvement, 2) ocular-cardiac-cutaneous-central nervous system disease involvement, 3) musculoskeletal-cutaneous involvement, 4) pulmonary and intrathoracic lymph node involvement, and 5) extrapulmonary involvement.These five new clinical phenotypes will be useful to recruit homogenous cohorts in future biomedical studies.
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Affiliation(s)
| | - Sandra Freitag-Wolf
- Institute of Medical Informatics and Statistics, Christian-Albrechts-Universität, Kiel, Germany
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplant Unit, AOUS - Medical and Surgical Sciences and Neuroscience Dept, Siena University, Siena, Italy
| | | | - Paola Rottoli
- Respiratory Diseases and Lung Transplant Unit, AOUS - Medical and Surgical Sciences and Neuroscience Dept, Siena University, Siena, Italy
| | - Aleksandar Grubanovic
- Dept of Pneumology, University Medical Centre, Faculty of Medicine, Freiburg, Germany
| | - Annegret Müller
- Dept of Pneumology, University Medical Centre, Faculty of Medicine, Freiburg, Germany.,Dept of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital, Aachen, Germany
| | - Arne Jochens
- Institute of Medical Informatics and Statistics, Christian-Albrechts-Universität, Kiel, Germany
| | - Lukas Tittmann
- Popgen Biobank and Institute of Epidemiology, Christian-Albrechts-Universität, Kiel, Germany
| | - Jasmin Schnerch
- Dept of Pneumology, University Medical Centre, Faculty of Medicine, Freiburg, Germany.,Dept of Haematology and Oncology, University Medical Centre, Freiburg, Germany
| | - Carmela Olivieri
- Respiratory Diseases and Lung Transplant Unit, AOUS - Medical and Surgical Sciences and Neuroscience Dept, Siena University, Siena, Italy
| | - Annegret Fischer
- Institute of Clinical Molecular Biology, Christian-Albrechts-Universität, Kiel, Germany
| | - Dragana Jovanovic
- University Hospital of Lung Diseases, Clinical Centre of Serbia, Belgrade, Serbia
| | - Snežana Filipovic
- University Hospital of Lung Diseases, Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Paul Bresser
- Pulmonology Dept, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - René Jonkers
- Pulmonology Dept, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | | | - Ling-Pei Ho
- Oxford Sarcoidosis Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Karoline I Gaede
- Medical Hospital, Research Center Borstel, Borstel, Germany.,Leibniz Center for Medicine and Biosciences, Airway Research Center North, Member of the German Center for Lung Research, Borstel, Germany
| | - Peter Zabel
- Medical Hospital, Research Center Borstel, Borstel, Germany.,Leibniz Center for Medicine and Biosciences, Airway Research Center North, Member of the German Center for Lung Research, Borstel, Germany
| | - Anna Dubaniewicz
- Dept of Pulmonology, Medical University of Gdansk, Gdansk, Poland
| | | | - Robert Kieszko
- Dept of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
| | - Janusz Milanowski
- Dept of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
| | | | | | - Martin Petrek
- Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic.,University Hospital Olomouc, Olomouc, Czech Republic
| | - Vitezslav Kolek
- Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic.,University Hospital Olomouc, Olomouc, Czech Republic
| | - Michael P Keane
- University College Dublin, Dublin, Ireland.,St Vincent's University Hospital, Dublin, Ireland
| | - Sarah O'Beirne
- University College Dublin, Dublin, Ireland.,St Vincent's University Hospital, Dublin, Ireland
| | - Seamas Donnelly
- University College Dublin, Dublin, Ireland.,St Vincent's University Hospital, Dublin, Ireland
| | | | | | - Ulrich Costabel
- Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen gGmbH, Universitätsklinik Essen, Essen, Germany
| | - Francesco Bonella
- Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen gGmbH, Universitätsklinik Essen, Essen, Germany
| | | | | | | | - Mauritio Luisetti
- Pulmonology Unit, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Zamir Kadija
- Pulmonology Unit, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | | | - Martina Vašáková
- Thomayer Hospital, Prague, Czech Republic.,First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martina Sterclova
- Thomayer Hospital, Prague, Czech Republic.,First Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Jiří Homolka
- Prague General Hospital, Charles University, Prague, Czech Republic
| | - Alena Slováková
- Prague General Hospital, Charles University, Prague, Czech Republic
| | - Yvonne Kendrick
- Oxford Sarcoidosis Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anjali Crawshaw
- Oxford Sarcoidosis Service, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Wim Wuyts
- University Hospital, Leuven, Belgium
| | | | | | - Dominique Valeyre
- Service de Pneumologie, Groupe Hospitalier Avicenne-Jean Verdier-René Muret, Bobigny, France
| | - Venerino Poletti
- Pulmonary Unit, Dept of Thoracic Diseases, Azienda USL Romagna, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Hubertus Wirtz
- Dept of Pneumology, University Hospital, Leipzig, Germany
| | - Antje Prasse
- Dept of Pneumology, University Medical Centre, Faculty of Medicine, Freiburg, Germany.,Dept of Pneumology, Hannover Medical School, Hannover, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Christian-Albrechts-Universität, Kiel, Germany.,Dept of Internal Medicine, Christian-Albrechts-Universität, Kiel, Germany
| | - Michael Krawczak
- Institute of Medical Informatics and Statistics, Christian-Albrechts-Universität, Kiel, Germany
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