Background/Purpose: Sarcoidosis is a multisystemic granulomatous disorder of unknown origin. The central role of macrophages and granuloma formation, the predominant involvement of lung and skin, and risk populations (e.g. fire fighters) points towards causative airborne antigen(s). This study has been set to analyze seasonal clustering of acute sarcoidosis in south-west Germany and correlations to particulate matter air pollution.

Methods: Patients with acute sarcoidosis (as defined by bihilar lymphadenopathy, ankle swelling and/ or erythema nodosum) who presented between January 1994 and December 2018 were included in this retrospective study. Disease onset (seasonal clustering) and associations to air pollution (particulate matter (PM₁₀)) were analyzed.

Results: We were able to include 186 patients (47.3% female, mean age 37, complete Löfgren triad in 72%) with acute sarcoidosis. Over the whole study period disease onsets peaked in the first third of the year (January 17.7 % of cases, February 11.8 %, March 12.4 %, April 12.4 %, May 9.7 %, June 9.7 %, July 7.5 %, August 3.2 %, September 2.7 %, October 1.1 %, November 2.1 %, December 9.7 %). Increase of local PM₁₀ (values ranging between 15 and 40 µg/m³) was followed by a higher number of disease cases in the study period from 2004 to 2015.

Conclusion: In south-west Germany the onset of acute sarcoidosis clusters in the first third of the year. Particulate matter air pollution might be one factor involved.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/seasonal-clustering-of-acute-sarcoidosis-in-south-west-germany-and-associations-with-particulate-matter-air-pollution/