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Subramanian K, Martinez J, Osborne JR, Nicholson S, Van Parys J, Singh P, An A, Heise R, Al-Hakim T, Buchanan M, Youn T. Access to cardiac PET/CT by sarcoidosis patients and cost-effectiveness analysis of cardiac PET/MR compared to the standard of care. Clin Imaging 2023; 94:50-55. [PMID: 36493682 PMCID: PMC9812891 DOI: 10.1016/j.clinimag.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/08/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
IMPORTANCE Cardiac sarcoidosis is associated with a high mortality rate. Given multiple barriers to obtaining cardiac PET imaging, we suspect individuals with access to this imaging modality are not representative of the Sarcoid patient population, which in the United States are predominantly Black females. OBJECTIVE To evaluate the demographics of patients with cardiac PET access and the cost-effectiveness of cardiac PET/MR imaging relative to standard of care. DESIGN This is a retrospective, observational study. The demographic information of patients with suspected cardiac sarcoidosis and cardiac PET/CT imaging within a national registry of sarcoidosis were reviewed (n = 4561). An individual-level, continuous, time-state transition model was used for the evaluation of long-term cost-effectiveness for the combined cardiac PET/MR compared to standard of care cardiac MR followed by cardiac PET/CT. RESULTS Patients who underwent cardiac PET in the national registry had 88.35% higher odds of being male (p < 0.001) and 43.82% higher odds of being White (p = 0.003) than their counterparts who did not have cardiac PET imaging. Combined cardiac PET/MR had overall lower total lifetime costs ($8761 vs $10,777) and overall improved expected quality of life-years compared to the standard of care (0.77 vs 0.69). CONCLUSION AND RELEVANCE The findings suggest that patients with access to cardiac PET/CT are not representative of the patient population most likely to have cardiac sarcoidosis in this limited study evaluation. Universal insurance coverage should be considered for Cardiac PET imaging as same day cardiac PET and MR imaging has potential long-term cost and quality of life benefit.
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Affiliation(s)
- Kritika Subramanian
- Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America.
| | - Juana Martinez
- Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America
| | - Joseph R Osborne
- Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America
| | - Sean Nicholson
- Department of Policy Analysis and Management, Sloan, Cornell Institute for Public Affairs, New York, NY, United States of America
| | - Jessica Van Parys
- Department of Economics, Hunter College, City University of New York, New York, NY, United States of America
| | - Parmanand Singh
- Department of Cardiology, Weill Cornell Medicine, New York, NY, United States of America
| | - Anjile An
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Rachel Heise
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America
| | - Tamara Al-Hakim
- Foundation for Sarcoidosis Research, Chicago, IL, United States of America
| | - Mindy Buchanan
- Foundation for Sarcoidosis Research, Chicago, IL, United States of America
| | - Trisha Youn
- Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America
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2
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Savale L, Huitema M, Shlobin O, Kouranos V, Nathan SD, Nunes H, Gupta R, Grutters JC, Culver DA, Post MC, Ouellette D, Lower EE, Al-Hakim T, Wells AU, Humbert M, Baughman RP. WASOG statement on the diagnosis and management of sarcoidosis-associated pulmonary hypertension. Eur Respir Rev 2022; 31:31/163/210165. [PMID: 35140103 DOI: 10.1183/16000617.0165-2021] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/13/2021] [Indexed: 12/14/2022] Open
Abstract
Sarcoidosis-associated pulmonary hypertension (SAPH) is an important complication of advanced sarcoidosis. Over the past few years, there have been several studies dealing with screening, diagnosis and treatment of SAPH. This includes the results of two large SAPH-specific registries. A task force was established by the World Association of Sarcoidosis and Other Granulomatous disease (WASOG) to summarise the current level of knowledge in the area and provide guidance for the management of patients. A group of sarcoidosis and pulmonary hypertension experts participated in this task force. The committee developed a consensus regarding initial screening including who should undergo more specific testing with echocardiogram. Based on the results, the committee agreed upon who should undergo right-heart catheterisation and how to interpret the results. The committee felt there was no specific phenotype of a SAPH patient in whom pulmonary hypertension-specific therapy could be definitively recommended. They recommended that treatment decisions be made jointly with a sarcoidosis and pulmonary hypertension expert. The committee recognised that there were significant defects in the current knowledge regarding SAPH, but felt the statement would be useful in directing future studies.
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Affiliation(s)
- Laurent Savale
- Université Paris-Saclay; INSERM UMR_S 999; Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Marloes Huitema
- Dept of Cardiology, St. Antonius Hospital, Nieuwegein and University Medical Center Utrecht, Utrecht, The Netherlands
| | - Oksana Shlobin
- Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, USA
| | - Vasilis Kouranos
- Interstitial Lung Disease/Sarcoidosis Unit, Royal Brompton Hospital, London, UK.,National Heart and Lung Institute, Imperial College, London, UK
| | - Steven D Nathan
- Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, VA, USA
| | - Hiliaro Nunes
- INSERM UMR 1272, Université Sorbonne Paris Nord; Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, APHP, Hôpital Avicenne, Bobigny, France
| | - Rohit Gupta
- Dept of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA USA
| | - Jan C Grutters
- Dept of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, Nieuwegein and University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marco C Post
- Dept of Cardiology, St. Antonius Hospital, Nieuwegein and University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Elyse E Lower
- Dept of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | | | - Athol U Wells
- Interstitial Lung Disease/Sarcoidosis Unit, Royal Brompton Hospital, London, UK.,National Heart and Lung Institute, Imperial College, London, UK
| | - Marc Humbert
- Université Paris-Saclay; INSERM UMR_S 999; Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Robert P Baughman
- Dept of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
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3
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Innabi A, Alzghoul BN, Kalra S, Al-Hakim T, Buchanan M, Shivas T, Xue W, Gomez-Manjarres D, Patel DC. Sarcoidosis among US Hispanics in a Nationwide Registry. Respir Med 2021; 190:106682. [PMID: 34788736 DOI: 10.1016/j.rmed.2021.106682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/14/2021] [Accepted: 11/08/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Sarcoidosis has been well studied in multiple races and ethnic groups. However, there is a paucity of data that describes sarcoidosis in Hispanics. We aimed to determine the prevalence of Hispanic ethnicity, clinical characteristics and impact of sarcoidosis among Hispanics from a US based national registry. METHODS We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures questionnaire. This registry is a web-based, self-reported questionnaire that provides data related to demographics, diagnostics, organ involvement, treatment modalities, and the physical and psychosocial impact of sarcoidosis. We compared Hispanic patients to non-Hispanics. We performed multivariate logistic regression analysis adjusting for age, gender, education, income and insurance status and looked at the association between Hispanic ethnicity with depression, chronic pain syndrome, chronic fatigue syndrome, impact on family finances, employment-based disability and job termination. RESULTS Nine percent of the patients reported a Hispanic ethnicity and the majority of these patients self-identified as white women. The most common organs involved were the lungs (74.9%), central lymph nodes (53.8%), and peripheral lymph nodes (37.1%). Hispanics reported more peripheral nerves and peripheral lymph nodes involvement than non-Hispanics. Hispanics experienced more depression, sleep apnea, and chronic pain syndrome than non-Hispanics. The use of mobility assistive devices was more common among Hispanics, as well as employment-based disability, and disease-related job termination compared to non-Hispanics. The majority of Hispanics reported significantly more pain that interfered with the enjoyment of life than non-Hispanics. On multivariate logistic regression analysis, Hispanic ethnicity was associated with depression (adjusted odds ratio (aOR) = 1.5; 95% CI: 1.01-2.2), chronic pain syndrome (aOR = 1.7; 1.1-2.6), job termination due to sarcoidosis (aOR = 1.7; 1.1-2.7) and higher impact on family finances (aOR = 1.7; 1.1-2.5). CONCLUSION The clinical presentation of sarcoidosis in Hispanic patients differs from that in non-Hispanic patients living in the United States. These differences should be considered when managing Hispanic patients with sarcoidosis. We encourage more studies that investigate phenotyping among Hispanics with sarcoidosis.
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Affiliation(s)
- Ayoub Innabi
- Division of Pulmonary, Critical Care and Sleep Medicine; University of Florida; Gainesville, Florida, USA
| | - Bashar N Alzghoul
- Division of Pulmonary, Critical Care and Sleep Medicine; University of Florida; Gainesville, Florida, USA
| | - Saminder Kalra
- Division of Pulmonary, Critical Care and Sleep Medicine; University of Florida; Gainesville, Florida, USA
| | | | - Mindy Buchanan
- Foundation for Sarcoidosis Research; Chicago, Illinois, USA
| | - Tricha Shivas
- Foundation for Sarcoidosis Research; Chicago, Illinois, USA
| | - Wei Xue
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine; University of Florida; Gainesville, FL, USA
| | - Diana Gomez-Manjarres
- Division of Pulmonary, Critical Care and Sleep Medicine; University of Florida; Gainesville, Florida, USA
| | - Divya C Patel
- Division of Pulmonary, Critical Care and Sleep Medicine; University of Florida; Gainesville, Florida, USA.
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Harman NL, Gorst SL, Williamson PR, Barnathan ES, Baughman RP, Judson MA, Junk H, Kampstra NA, Sullivan EJ, Victorson DE, Walton M, Al-Hakim T, Nabulsi H, Singh N, Grutters JC, Culver DA. Scout - sarcoidosis outcomes taskforce. A systematic review of outcomes to inform the development of a core outcome set for pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2021; 38:e2021034. [PMID: 34744426 PMCID: PMC8552570 DOI: 10.36141/svdld.v38i3.10737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
Background: Clinical trials evaluating different management strategies for pulmonary sarcoidosis may measure different outcomes. This heterogeneity in outcomes can lead to waste in research due to the inability to compare and combine data. Core outcome sets (COS) have the potential to address this issue and here we describe a systematic review of outcomes as the first step in the development of a COS for pulmonary sarcoidosis research. Methods: A search of clinical trial registries for phase II, III and IV trials of pulmonary sarcoidosis was undertaken along with a rapid review of the patient perspective literature. Each study was screened for eligibility and outcomes extracted verbatim from the registry entry or publication then reviewed, grouped and categorised using the COMET taxonomy. Results: 36 trial registry entries and 6 studies on patients’ perspective of pulmonary sarcoidosis were included reporting 56 and 82 unique outcomes respectively across 23 domains. The most frequently reported outcome domain was “respiratory, thoracic and mediastinal outcomes”. However, the patients’ perspective literature identified outcomes in the “personal circumstances” and “societal/carer burden” domains that were not reported in any of the included trial registrations. Conclusions: Using both clinical trial registry data and published literature on patients’ perspective has allowed rapid review of outcomes measured and reported in pulmonary sarcoidosis research. The use of multiple sources has led to the development of a comprehensive list of outcomes that represents the first step in the development of a COS for use in future pulmonary sarcoidosis research.
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Affiliation(s)
- Nicola L Harman
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Sarah L Gorst
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | | | - Robert P Baughman
- Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Marc A Judson
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, New York, USA
| | - Heidi Junk
- Patient Advocate - Foundation for Sarcoidosis Research
| | - Nynke A Kampstra
- Dept of Value-Based Healthcare, St Antonius Hospital, Nieuwegein, The Netherlands.,The Foundation for Sarcoidosis Research, Chicago, Illinois, USA
| | - Eugene J Sullivan
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ Healthcare), Nijmegen, The Netherlands
| | | | - Marc Walton
- Northwestern University Feinberg School of Medicine, Evanston, IL, USA
| | | | - Hana Nabulsi
- Janssen Research and Development, Titusville, NJ, USA
| | - Noopur Singh
- Janssen Research and Development, Titusville, NJ, USA
| | - Jan C Grutters
- The Foundation for Sarcoidosis Research, Chicago, Illinois, USA.,Interstitial Lung Diseases Centre of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Daniel A Culver
- Division of Heart & Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
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5
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Alzghoul BN, Amer FN, Barb D, Innabi A, Mardini MT, Bai C, Alzghoul B, Al-Hakim T, Singh N, Buchanan M, Serchuck L, Gomez Manjarres D, Woodmansee WW, Maier LA, Patel DC. Prevalence and characteristics of self-reported hypothyroidism and its association with nonorgan-specific manifestations in US sarcoidosis patients: a nationwide registry study. ERJ Open Res 2021; 7:00754-2020. [PMID: 33816601 PMCID: PMC8005680 DOI: 10.1183/23120541.00754-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/24/2020] [Indexed: 12/15/2022] Open
Abstract
Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis. We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with nonorgan-specific manifestations. 14% of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multiorgan sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal gland involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR) 1.3, 95% CI 1.01-1.6), antidepressant use (aOR 1.3, 95% CI 1.1-1.7), obesity (aOR 1.7, 95% CI 1.4-2.1), sleep apnoea (aOR 1.7, 95% CI 1.3-2.2), chronic fatigue syndrome (aOR 1.5, 95% CI 1.2-2) and was borderline associated with fibromyalgia (aOR 1.3, 95% CI 1-1.8). Physical impairment was more common in patients with hypothyroidism. Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multiorgan sarcoidosis, fatigue and depression.
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Affiliation(s)
- Bashar N. Alzghoul
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Farah N. Amer
- Dept of Internal Medicine, University of Central Florida/North Florida Regional Medical Center, Gainesville, FL, USA
| | - Diana Barb
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Ayoub Innabi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Mamoun T. Mardini
- Dept of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
- Dept of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Chen Bai
- Dept of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Bara Alzghoul
- Dept of Internal Medicine, University of Kentucky, Lexington, KY, USA
| | | | - Noopur Singh
- Foundation for Sarcoidosis Research, Chicago, IL, USA
| | | | | | - Diana Gomez Manjarres
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Whitney W. Woodmansee
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Lisa A. Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Dept of Medicine, School of Medicine, Dept of Environmental/Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - Divya C. Patel
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
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Baughman RP, Lower EE, Buchanan M, Rottoli P, Drent M, Sellares J, Terwiel M, Elfferich M, Francesqui J, Barriuso Cabrerizo MR, Sweiss N, Martone F, Al-Hakim T, Judson MA. Risk and outcome of COVID-19 infection in sarcoidosis patients: results of a self-reporting questionnaire. Sarcoidosis Vasc Diffuse Lung Dis 2020; 37:e2020009. [PMID: 33597796 PMCID: PMC7883514 DOI: 10.36141/svdld.v37i4.10726] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/29/2020] [Indexed: 01/02/2023]
Abstract
Background: It has been suggested that sarcoidosis patients, especially those on immunosuppressive medications, are at increased risk for COVID-19 infection and more severe disease. Methods: A questionnaire was developed in four languages (English, Dutch, Italian, and Spanish). The questionnaire queried whether patients had been infected with COVID-19 and outcome of the infection. Risk factors for COVID-19 infection were collected. Results: A total of 5200 sarcoidosis patients completed the questionnaire with 116 (2.23%) reporting infection and 18 (15.8%) required hospitalization. Increased hazard ratio (HR) for COVID-19 infection were seen for those with a COVID-19 infected roommate (HR=27.44, p<0.0001), health care provider (HR=2.4, p=0.0001), pulmonary sarcoidosis (HR=2.48, p=0.001), neurosarcoidosis (HR=2.02, p<0.01), or rituximab treatment (HR=5.40, p<0.0001). A higher rate of hospitalization was found for those with underlying heart disease (HR=3.19 (1.297-7.855), p<0.02). No other feature including race, other immunosuppressive agent, age, or underlying condition was associated with a significant increased risk for infection or more severe disease. Conclusion: The overall rate of COVID-19 was 2.23%, suggesting an increased rate of COVID-19 infection. However, when an analysis of the questionnaires of sarcoidosis and non-sarcoidosis patients was performed in one localized area over this time period, the rate of COVID-19 infection was similar in both groups. Sarcoidosis patients who cohabitated with COVID-19 infected individuals, worked in health care, had pulmonary or neurologic sarcoidosis, or were treated with rituximab had an increased risk for COVID-19 infection. No significant increased risk for hospitalization could be identified based on age, race, gender or any specific immunosuppressive treatment. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (4): e2020009)
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Affiliation(s)
- Robert P Baughman
- University of Cincinnati Medical Center, Department of Medicine, Cincinnati, OH, USA
| | - Elyse E Lower
- University of Cincinnati Medical Center, Department of Medicine, Cincinnati, OH, USA
| | | | - Paola Rottoli
- Specialization School of Respiratory Diseases, Dept of Medical, Surgical and Neurological Sciences, Siena University, Italy
| | - Marjolein Drent
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands.,Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht, the Netherlands.,ild care foundation research team, Ede, the Netherlands
| | - Jacobo Sellares
- Servei de Pneumologia, Respiratory Institute, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomedica en Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Spain.,Interstitial Lung Diseases Core member, European Reference Network for Rare Diseases of the Respiratory System (ERN-LUNG), Spain
| | - Michelle Terwiel
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Marjon Elfferich
- ild care foundation research team, Ede, the Netherlands.,Hospital Gelderse Vallei, Ede, the Netherlands
| | - Joel Francesqui
- Servei de Pneumologia, Respiratory Institute, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | | | - Nadera Sweiss
- Division of Rheumatology and Medical Director of the Arthritis Clinic and Bernie Mac Sarcoidosis Translational Advanced Research Center (STAR), University of Illinois Chicago, Chicago IL, USA
| | | | | | - Marc A Judson
- Department of Medicine, Albany Medical College, Albany NY, USA
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7
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Alzghoul B, Amer F, Mardini M, Bai C, Alzghoul B, Innabi A, Al-Hakim T, Singh N, Manjarres DG, Patel D. PREVALENCE AND CHARACTERISTICS OF HYPOTHYROIDISM AND ITS ASSOCIATION WITH NON-ORGAN RELATED MANIFESTATIONS IN US PATIENTS WITH SARCOIDOSIS. Chest 2020. [DOI: 10.1016/j.chest.2020.08.992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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