Clinical Characteristics of Patients in a Case Control Study of Sarcoidosis

TLDR

Sarcoidosis presentation may vary by sex, race, and age. The study used the ACCESS sarcoidosis assessment system to determine organ involvement across the entire cohort and subgroups defined by sex, race, and age (<40 or ≥40 years). ACCESS enrolled 736 patients within six months of diagnosis at ten U.S. centers, applying a standardized assessment to evaluate organ involvement in a racially, sex, and age‑diverse cohort.

Abstract

Sarcoidosis may be affected by sex, race, and age. A Case Control Etiologic Study of Sarcoidosis (ACCESS) enrolled 736 patients with sarcoidosis within 6 mo of diagnosis from 10 clinical centers in the United States. Using the ACCESS sarcoidosis assessment system, we determined organ involvement for the whole group and for subgroups differentiated by sex, race, and age (less than 40 yr or 40 yr and older). The study population was heterogeneous in terms of race (53% white, 44% black), sex (64% female, 36% male), and age (46% < 40 yr old, 54% ⩾ 40 yr old). Women were more likely to have eye and neurologic involvement ( χ2 = 4.74, p < 0.05 and χ2 = 4.60, p < 0.05 respectively), have erythema nodosum ( χ2 = 7.28, p < 0.01), and to be age 40 yr or over ( χ2 = 6.07, p < 0.02) whereas men were more likely to be hypercalcemic ( χ2 = 7.38, p < 0.01). Black subjects were more likely to have skin involvement other than erythema nodosum ( χ2 = 5.47, p < 0.05), and eye ( χ2 = 13.8, p < 0.0001), liver ( χ2 = 23.3, p < 0.0001), bone marrow ( χ2 = 18.8, p < 0.001), and extrathoracic lymph node involvement ( χ2 = 7.21, p < 0.01). We conclude that the initial presentation of sarcoidosis is related to sex, race, and age.