Ethnicity-Related Differences in the Clinical Presentation of Sarcoidosis in Spain (SARCOGEAS-SEMI Registry)

Roberto Pérez-Alvarez¹, Soledad Retamozo^2,3, Belchin Kostov⁴, Andrés González García⁵, Carmen Yllera Gutiérrez⁶, Miguel López Dupla⁷, Esperanza Bueno Juana⁸, Ana Alguacil⁹, Juan Escobedo Palau¹⁰, Francisco Javier Rascón¹¹, Jose Salvador Garcia Morillo¹², Carles Tolosa Vilella¹³, Eva Fonseca Aizpuru¹⁴, Mariona Bonet¹⁵, Naya Faro Minguez¹⁶, Anna Sánchez Biosca¹⁷, Ana Belén Madroñero¹⁸, Cristina Soler I Ferrer¹⁹, Enrique Peral Gutiérrez De Ceballos²⁰, Jorge Francisco Gómez Cerezo²¹, Gracia Cruz Caparrós²², Patricia Perez Guerrero²³, Sergio Rodríguez Fernández²⁴, Alberto Gato Diez²⁵, Blanca Pinilla²⁶, Miriam Akasbi²⁷, Angel Robles²⁸, Inmaculada Ojeda²⁹, María José Vives³⁰, María Penadés Vidal³¹, Moisés De Vicente³², César Morcillo³³, Lucio Pallarés¹¹, Pilar Brito-Zerón^3,34 and SARCOGEAS Registry, GEAS-SEMI, ¹Department of Internal Medicine, Hospital Alvaro Cunqueiro, Vigo, Vigo, Spain, ²Rheumatology Unit, Hospital Privado Centro Médico de Córdoba, Postgraduate Career of Rheumatology Catholic University of Córdoba, Fundación para las Ciencias Biomédicas de Córdoba (FUCIBICO), Cordoba, Argentina, ³Laboratory of Systemic Autoimmune Diseases “Josep Font”, CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, Barcelona, Barcelona, Spain, ⁴Primary Care Research Group, IDIBAPS, Centre d’Assistència Primària ABS Les Corts, CAPSE, Barcelona, Barcelona, Spain, ⁵Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Madrid, Spain, ⁶Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Oviedo, Spain, ⁷Department of Internal Medicine, Hospital Universitari Joan XXIII, Tarragona, Tarragona, Spain, ⁸Department of Internal Medicine, Hospital Clínico, Zaragoza, Zaragoza, Spain, ⁹Department of Internal Medicine, Hospital Virgen de la Salud, Toledo, Toledo, Spain, ¹⁰Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Zaragoza, Spain, ¹¹Department of Internal Medicine, Hospital Son Espases. Palma de Mallorca, Palma de Mallorca, Spain, ¹²Department of Internal Medicine, Hospital Virgen del Rocio, Sevilla, Sevilla, Spain, ¹³Department of Internal Medicine, Hospital Parc Taulí, Sabadell, Sadabell, Spain, ¹⁴Department of Internal Medicine, Hospital de Cabueñes, Gijón, Gijón, Spain, ¹⁵Department of Internal Medicine, Althaia, Xarxa Assistencial de Manresa, Manresa, Spain, ¹⁶Department of Internal Medicine, Hospital Clínico San Cecilio, Granada, Granada, Spain, ¹⁷Department of Internal Medicine, Hospital de Santa Coloma de Gramenet Barcelona, Barcelona, Spain, ¹⁸Department of Internal Medicine, Hospital General San Jorge, Huesca, Huesca, Spain, ¹⁹Department of Internal Medicine, Hospital de Santa Caterina, Girona, Girona, Spain, ²⁰Department of Internal Medicine, Hospital Virgen Macarena, Sevilla, Sevilla, Spain, ²¹Department of Internal Medicine, Hospital Infanta Sofía, San Sebastián, San Sebastian, Spain, ²²Department of Internal Medicine, Hospital de Poniente El Ejido, Almería, Almería, Spain, ²³Department of Internal Medicine, Hospital Universitario Puerta del Mar, Cádiz, Cadiz, Spain, ²⁴Department of Internal Medicine, Hospital da Barbanza, A Coruña, A Coruña, Spain, ²⁵Department of Internal Medicine, Complejo Hospitalario Albacete, Albacete, Albacete, Spain, ²⁶Department of Internal Medicine, Hospital Gregorio Marañón, Madrid, Madrid, Spain, ²⁷Department of Internal Medicine, Hospital Infanta Leonor, Madrid, Madrid, Spain, ²⁸Department of Internal Medicine, Hospital La Paz, Madrid, Madrid, Spain, ²⁹Department of Internal Medicine, Hospital Valle del Guadiato, Córdoba, Cordoba, Spain, ³⁰Department of Internal Medicine, Parc Sanitari San Joan de Déu, San Boi de Llobregat, Barcelona, Spain, ³¹Department of Internal Medicine, Hospital De Manises, Valencia, Valencia, Spain, ³²Department of Internal Medicine, Hospital Nuestra Señora del Prado, Talavera, Talavera, Spain, ³³Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Barcelona, Spain, ³⁴Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona., Bacelona, Spain

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Ethnic studies and sarcoidosis

Session Information

Date: Sunday, November 13, 2016

Title: Miscellaneous Rheumatic and Inflammatory Diseases - Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To evaluate the influence of ethnicity on the clinical presentation of sarcoidosis in a large multicenter cohort from Southern Europe.

Methods: In January 2016, the Autoimmune Diseases Study Group (GEAS-SEMI) created a national registry (SARCOGEAS) of patients with sarcoidosis. Sarcoidosis was diagnosed in agreement with the criteria proposed by the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) 1999 statement on sarcoidosis. Organ involvement was retrospectively determined in each patient at the time of diagnosis using the 2014 WASOG organ assessment instrument. Ethnicity was classified according to the FDA classification. Two outcomes (association with neoplasia and death) were assessed at the end of follow-up.

Results: The cohort consisted of 979 patients (85% biopsy-proven), including 562 (57%) women and 417 (43%) men, with a mean age at diagnosis of 47.02 ± 15.44 years. With respect to the FDA ethnic classification, 858 (88%) patients were classified as White, 83 (8%) as Hispanic, 21 (2%) as Black/African American and 17 (2%) as Asian. Epidemiologically, the lowest frequency of women was reported in Blacks/African Americans (24% vs. 58%W, 59%A and 60%H, p=0.018) Radiologically, the highest frequency of radiological stages involving the lung parenchyma was found in Hispanics (79% vs. 71%BAA, 67%W and 56%A, p=0.041). With respect to extrathoracic WASOG involvements, the highest frequencies of cutaneous involvement were found in Hispanics and Whites (41% and 35% vs. 12%A and 9%BAA, p=0.011), ocular involvement in Blacks/African Americans (29%% vs. 14%H, 11%W and 0%A, p=0.021), liver involvement in Blacks/African Americans (38% vs. 16%H, 12%W and 0%A, p=0.021), and kidney involvement in Blacks/African Americans and Asians (14% vs. 11% vs 5%W and 1%H, p=0.037) (Figure 1). After a mean follow-up of 87.9 months, neoplasia was reported in 112 (11%) patients and 91 (9%) patients died. Sarcoidosis was more frequently related to neoplasia in Whites (13% vs. 6%H, 0%BAA and 0%A, p=0.042), who also had the highest mortality rate (10% vs. 5%BAA, 1%H and 0%A, p=0.015).

Conclusion: In a predominantly White Southern European population of patients diagnosed with sarcoidosis, ethnicity played a significant role in the presentation and prognosis of the disease even after taking into account the lower frequencies of ethnicities associated with poor outcomes (Black/African Americans and Hispanics). Consideration of ethnic disparities in the clinical presentation of sarcoidosis may be essential in reaching an early diagnosis, the search for histopathological confirmation and the prompt introduction of specific therapy in Mediterranean patients with sarcoidosis.

Disclosure: R. Pérez-Alvarez, None; S. Retamozo, None; B. Kostov, None; A. González García, None; C. Yllera Gutiérrez, None; M. López Dupla, None; E. Bueno Juana, None; A. Alguacil, None; J. Escobedo Palau, None; F. J. Rascón, None; J. S. Garcia Morillo, None; C. Tolosa Vilella, None; E. Fonseca Aizpuru, None; M. Bonet, None; N. Faro Minguez, None; A. Sánchez Biosca, None; A. B. Madroñero, None; C. Soler I Ferrer, None; E. Peral Gutiérrez De Ceballos, None; J. F. Gómez Cerezo, None; G. Cruz Caparrós, None; P. Perez Guerrero, None; S. Rodríguez Fernández, None; A. Gato Diez, None; B. Pinilla, None; M. Akasbi, None; A. Robles, None; I. Ojeda, None; M. J. Vives, None; M. Penadés Vidal, None; M. De Vicente, None; C. Morcillo, None; L. Pallarés, None; P. Brito-Zerón, None.

To cite this abstract in AMA style:

Pérez-Alvarez R, Retamozo S, Kostov B, González García A, Yllera Gutiérrez C, López Dupla M, Bueno Juana E, Alguacil A, Escobedo Palau J, Rascón FJ, Garcia Morillo JS, Tolosa Vilella C, Fonseca Aizpuru E, Bonet M, Faro Minguez N, Sánchez Biosca A, Madroñero AB, Soler I Ferrer C, Peral Gutiérrez De Ceballos E, Gómez Cerezo JF, Cruz Caparrós G, Perez Guerrero P, Rodríguez Fernández S, Gato Diez A, Pinilla B, Akasbi M, Robles A, Ojeda I, Vives MJ, Penadés Vidal M, De Vicente M, Morcillo C, Pallarés L, Brito-Zerón P. Ethnicity-Related Differences in the Clinical Presentation of Sarcoidosis in Spain (SARCOGEAS-SEMI Registry) [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/ethnicity-related-differences-in-the-clinical-presentation-of-sarcoidosis-in-spain-sarcogeas-semi-registry/. Accessed .

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