Sarcoidosis: Epidemiology and clinical insights

Abstract

Sarcoidosis is characterized by noncaseating granulomas which form in almost any part of the body, primarily in the lungs and/or thoracic lymph nodes. Environmental exposures in genetically susceptible individuals are believed to cause sarcoidosis. There is variation in incidence and prevalence by region and race. Males and females are almost equally affected, although disease peaks at a later age in females than in males. The heterogeneity of presentation and disease course can make diagnosis and treatment challenging. Diagnosis is suggestive in a patient if one or more of the following is present: radiologic signs of sarcoidosis, evidence of systemic involvement, histologically confirmed noncaseating granulomas, sarcoidosis signs in bronchoalveolar lavage fluid (BALF), and low probability or exclusion of other causes of granulomatous inflammation. No sensitive or specific biomarkers for diagnosis and prognosis exist, but there are several that can be used to support clinical decisions, such as serum angiotensin‐converting enzyme levels, human leukocyte antigen types, and CD4 Vα2.3+ T cells in BALF. Corticosteroids remain the mainstay of treatment for symptomatic patients with severely affected or declining organ function. Sarcoidosis is associated with a range of adverse long‐term outcomes and complications, and with great variation in prognosis between populations. New data and technologies have moved sarcoidosis research forward, increasing our understanding of the disease. However, there is still much left to be discovered. The pervading challenge is how to account for patient variability. Future studies should focus on how to optimize current tools and develop new approaches so that treatment and follow‐up can be targeted to individuals with more precision.

Relative incidence of interstitial lung diseases in Brazil

“…In comparison with prevalence studies, a lower proportion is expected due to a better prognosis of sarcoidosis. 35 Moreover, the incidence and prevalence of sarcoidosis vary across regions and even within countries. 35 In Brazil, the epidemiology of sarcoidosis is largely unknown.…”

Case Report:Sarcoidosis with Peripheral neuropathy

“…These activated cells discharge various mediators, including cytokines, chemokines, and reactive oxygen species that may be involved in the progression of disease . Many studies hypothesized that genetic susceptibility, environmental factors, putative antigens and autoimmunity in the development of this diseases [19].Infectious agents,Noninfectious agents,Immune-related diseases and Cancer were mentioned for differential diagnosis of sarcoidosis [20].Neurological involvement in sarcoidosis is relatively uncommon, with a reported prevalence of 3 to 10% [21].Neurological manifestations are rarely the first or only symptom of sarcoidosis,with 84 to 94 percent of cases experiencing coexisting systemic manifestations, especially in the lungs and intrathoracic lymph nodes [22]. The patient in this case recovered well,After a period of treatment,her daily life significantly unaffected.…”

Novel genetic loci, lifestyle factors, and inflammatory markers identified as risk factors for sarcoidosis

“…Existing evidence regarding the link between physical activity, obesity and sarcoidosis is limited and inconclusive. [68][69][70][71] While two cohort studies involving a large number of women identified a positive relationship between weight gain and adult obesity with heightened sarcoidosis incidence, 68,69 a nested case-control study observed a positive association for obesity but not for overweight 72 and a retrospective case-control study observed no significant association between elevated BMI and sarcoidosis risk 70 . Such discrepancies might stem from the imprecision of BMI as a measure of obesity or variations in study populations.…”