• Healthcare Delivery

    Shedding More Light on Sarcoidosis

Our immune system is designed to repel disease, but occasionally it malfunctions. One potential result of an immune system overreaction is sarcoidosis—the growth of inflammatory cells (granulomas) in different parts of the body. This disease, which appears most commonly in the lungs, may sometimes be painful, debilitating, and potentially life threatening.

Chest x-ray showing sarcoidosis (arrows, left) and normal results (right)

According to the Foundation for Sarcoidosis Research, “the disease can affect people of any age, race and gender.  However, it is most common among adults between the ages of 20 and 40 and in certain ethnic groups. Disease severity [and the form in which it occurs] can vary by race or ethnicity, [and] is slightly more common in women than in men.”

Not a lot more is known about sarcoidosis, but Mayo Clinic researchers hope to lessen the uncertainty.

Rochester Epidemiology Project Delivers Again

In a recent study, a team of researchers, led by Eric Matteson, M.D., a rheumatologist and health sciences researcher at Mayo Clinic, used linked medical records from the Rochester Epidemiology Project to examine the medical information of people who received a new diagnosis of sarcoidosis from 1976 to 2013 in Olmsted County, Minnesota. They found 345 cases, divided between men and women (171 and 174 respectively).

“The Rochester Epidemiology Project is a powerful resource for detecting how disease actually occurs in patients in the community,” says Dr. Matteson. “Studies such as this demonstrate the true occurrence of such manifestations and bring the disease into a useful clinical perspective.”

According to Dr. Matteson, this is the first study to use a community’s medical records to investigate the different ways sarcoidosis affects men and women.

“To be able to identify environmental, behavioral and genetic commonalities between patients is the key to treatment and prevention,” he says. “Because we also examined the individual medical records and pathology reports – not just medical coding information – we were able to be quite certain of the correctness of the diagnosis, thus confirming the reliability of the patients’ additional health-related information.”

This combination of data points, which gives us a complete picture of the whole patient, is essential in understanding disease and finding ways to treat them.

New Findings, New Questions

The research team found that the age at diagnosis was significantly higher among women (48.3 years) than men (42.8 years).

“We also noted that women appear to have more disease in areas outside of the lung, which was not expected,” says Dr. Matteson.

Because of this, he warns, “Women may initially have symptoms of skin disease and eye inflammation, which should alert clinicians to search for lung disease related to sarcoidosis as the possible underlying cause of the symptoms.”

Of the patients in the study group, 98 percent of women and 96 percent of men had sarcoidosis in the lungs. However, lung-related symptoms were much more common among men than women (51 versus 36 percent). The researchers noted that eye inflammation was seen six times more often in women than men, and skin disease was seen in 25 percent of women versus only 12 percent of men.

The team found some other inconsistencies in comparing the symptoms and disease characteristics between their study group and other studies (as well as among those studies), leaving them determined to continue to seek answers.

- Elizabeth Zimmermann Young, March 23, 2017