Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: To analyse the correlation between Scadding radiological stages and the main phenotypic features at diagnosis (epidemiology, clinical patterns at presentation, extrathoracic disease and need for initial systemic therapy) in one of the largest cohorts of patients with sarcoidosis reported from Southern Europe.
Methods: The SARCOGEAS-Study Group was formed in 2015 including a multicenter database of consecutive patients diagnosed with sarcoidosis according to the WASOG 1999 criteria. Extrathoracic disease at diagnosis was defined according to the 2014 WASOG organ assessment instrument and the extrathoracic clusters proposed by Schupp et al.
Results: 1230 patients were finally analysed (712 women, mean age 47.3 yrs). Scadding radiologic stage at diagnosis consisted of stage 0 in 98 (8%) patients, stage I in 395 (32%), stage II in 500 (41%), stage III in 195 (16%) and stage IV in 42 (3%) patients. Epidemiologically, age at diagnosis was clearly linked with the Scadding stage, with younger mean ages being reported for stages I and II (p=0.001). With respect to extrathoracic disease, the highest frequencies of the organ-by-organ WASOG involvements are reported in stage 0 (skin, liver, spleen, ENT, nervous system and bone marrow), stage I (salivary glands, bone/joint) and stage IV (extra-thoracic lymph node, eye, kidney, calcium-vitamin D and heart) (FIGURE 1). The three SchappÕs extrathoracic clusters are overrepresented in stage 0. Patients with stage IV had the highest frequencies of both need of and aggressiveness of therapy, while patients with stage I had the lowest frequencies. Pulmonary fibrosis was related to a higher mean age at diagnosis (55 vs 47 yrs, p<0.001), a higher mean number of extrathoracic organs involved (1.5 vs 1.1, p=0.045), a higher frequency of calcium/vitamin D WASOG involvement (17% vs 7%, p=0.047) and a higher frequency of need for therapy (81% vs 49%, p<0.001); no statistically-significant differences were found between the stages II and III.
Conclusion: We found a significant association between Scadding stages and sarcoidosis phenotype at the time of diagnosis, including epidemiological profile, extrathoracic involvement and initial therapeutic management. However, the key determinant in phenotyping the disease at diagnosis was the involvement of each organ more than the classification using the Scadding stages.
To cite this abstract in AMA style:Retamozo S, Pérez-Alvarez R, Brito-Zerón P, Kostov B, Feijoo Massó C, Fraile G, González-García A, Gómez De La Torre R, De-Escalante B, Lopez-Dupla M, Alguacil A, Chara-Cervantes J, Pérez-Conesa M, Rascón FJ, Garcia Morillo JS, Perez Guerrero P, Fonseca Aizpuru E, Akasbi M, Bonet M, Callejas JL, De La Red Bellvis G, Calvo Begueria E, Soler i Ferrer C, Peral Gutiérrez De Ceballos E, Gómez-Cerezo JF, Cruz Caparrós G, Rodríguez Fernández S, Pinilla B, Gato Diez A, Rolo A, Morcillo C, Robles A, Ojeda I, Vives MJ, de-Miguel B, Penadés Vidal M, De Vicente M, Bosh X, Pérez-de-Lis M, González-García A, Yllera Gutiérrez C, Gracia-Tello B, Pedrosa M, Perez-Gonzalez A, Tolosa C, Sisó-Almirall A, Pallarés L, Ramos-Casals M. Differentiated Phenotypes at Diagnosis of Sarcoidosis According to the Scadding Classification: Analysis in 1230 Patients [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/differentiated-phenotypes-at-diagnosis-of-sarcoidosis-according-to-the-scadding-classification-analysis-in-1230-patients/. Accessed June 15, 2021.
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