Session 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.
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 December 2, 2020.
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