دورية أكاديمية
أعرض في EDS

Late-onset sarcoidosis: a comparative study.

التفاصيل البيبلوغرافية
العنوان: Late-onset sarcoidosis: a comparative study.
المؤلفون: Varron L; From the Department of Internal Medicine (LV, CB, PS), Hôpital de la Croix-Rousse; Department of Respiratory Medicine (VC), Reference Center for Orphan Pulmonary Diseases, Hôpital Cardiovasculaire et Pneumologique Louis Pradel; and Department of Epidemiology (AMS), Hospices civils de Lyon, Claude Bernard University Lyon I, Lyon, France., Cottin V, Schott AM, Broussolle C, Sève P
المصدر: Medicine [Medicine (Baltimore)] 2012 May; Vol. 91 (3), pp. 137-143.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Immunosuppressive Agents/*therapeutic use , Sarcoidosis/*epidemiology , Sarcoidosis, Pulmonary/*diagnosis, Age of Onset ; Aged ; Aged, 80 and over ; Biopsy ; Female ; Follow-Up Studies ; France ; Humans ; Male ; Sarcoidosis/drug therapy ; Sarcoidosis/pathology ; Sarcoidosis, Pulmonary/drug therapy ; Survival Analysis ; Survival Rate
مستخلص: Sarcoidosis is not rare in patients aged more than 65 years, but studies of elderly patients with sarcoidosis are scarce. We analyzed the characteristics and outcomes of patients in a French teaching hospital with late-onset sarcoidosis, defined as sarcoidosis diagnosed in patients aged 65 years or older, and compared them with those of younger patients with sarcoidosis. From 2002 to 2006, 30 patients were identified as having late-onset sarcoidosis and were compared to 70 patients randomly selected aged younger than 65 years. We compared clinical characteristics, laboratory data at diagnosis, severity, therapy, and outcome. The female to male ratio was higher in the late-onset sarcoidosis group than in the younger group (5:1 vs. 1:1, respectively; p = 0.003). Asthenia (30% vs. 10%; p = 0.012), uveitis (33.3 vs. 8.6%; p = 0.002), and specific skin lesions (36.7% vs. 15.7%; p = 0.002) occurred more frequently in patients with late-onset sarcoidosis than in younger patients. On the contrary, asymptomatic chest radiograph abnormalities (p = 0.031) and erythema nodosum (p = 0.016) were not reported in the group of elderly patients. The 2 groups were similar with regard to race, other organ systems involved, pulmonary function, radiographic stage, laboratory values, and severity. The proportion of patients with accessory salivary glands (p = 0.002) and skin (p = 0.023) biopsies was more often contributory to the diagnosis in the late-onset group.After a mean follow-up of 50 months, 1 death related to pulmonary mycetoma and 2 others unrelated to sarcoidosis occurred in the late-onset sarcoidosis group. The 5-year survival rate was 93.3% in the late-onset group compared with 100% in the young-onset group (p = 0.03), while overall mortality was not significantly different. The 2 groups were similar with regard to oral corticosteroid therapy and immunosuppressive use, although steroid-related adverse events were more common in the elderly group.In conclusion, we found certain clinical and diagnostic peculiarities in patients with late-onset sarcoidosis. Asthenia, uveitis, and specific cutaneous lesions were more frequent in this group, whereas erythema nodosum and disclosure on a routine chest roentgenogram were not observed. Biopsy of the minor salivary glands appears to be particularly pertinent for the diagnosis. Evolution and therapeutic management were not different in the 2 groups. However, the patients aged more than 65 years had more side effects related to the corticosteroid therapy.
References: Abad S, Meyssonier V, Allali J, Gouya H, Giraudet AL, Monnet D, Parc C, Tenenbaum F, Alberini JL, Grabar S, Pesce F, Rollot F, Sicard D, Dhote R, Blanche P, Brezin AP. Association of peripheral multifocal choroiditis with sarcoidosis: a study of thirty-seven patients. Arthritis Rheum. 2004; 51: 974–982.
Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H Jr, Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ, McLennan G, Moller DR, Newman LS, Rabin DL, Rose C, Rybicki B, Weinberger SE, Terrin ML, Knatterud GL, Cherniak R. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med. 2001; 164: 1885–1889.
Berkmen YM. Radiologic aspects of intrathoracic sarcoidosis. Semin Roentgenol. 1985; 20: 356–375.
Blackburn D, Hux J, Mamdani M. Quantification of the risk of corticosteroid-induced diabetes mellitus among the elderly. J Gen Intern Med. 2002; 17: 717–720.
Byg KE, Milman N, Hansen S. Sarcoidosis in Denmark 1980–1994. A registry-based incidence study comprising 5536 patients. Sarcoidosis Vasc Diffuse Lung Dis. 2003; 20: 46–52.
Chapelon C, Uzzan B, Piette JC, Jacques C, Coche E, Godeau P. [Sarcoidosis in internal medicine. A cooperative study of 554 cases]. Ann Med Interne (Paris). 1984; 135: 125–131.
Chapman JT, Mehta AC. Bronchoscopy in sarcoidosis: diagnostic and therapeutic interventions. Curr Opin Pulm Med. 2003; 9: 402–407.
Chevalet P, Clement R, Rodat O, Moreau A, Brisseau JM, Clarke JP. Sarcoidosis diagnosed in elderly subjects: retrospective study of 30 cases. Chest. 2004; 126: 1423–1430.
Clement DS, Postma G, Rothova A, Grutters JC, Prokop M, de Jong PA. Intraocular sarcoidosis: association of clinical characteristics of uveitis with positive chest high-resolution computed tomography findings. Br J Ophthalmol. 2010; 94: 219–222.
DeRemee RA. The roentgenographic staging of sarcoidosis. Historic and contemporary perspectives. Chest. 1983; 83: 128–133.
Fretzayas A, Moustaki M, Vougiouka O. The puzzling clinical spectrum and course of juvenile sarcoidosis. World J Pediatr. 2011; 7: 103–110.
Herbort CP, Rao NA, Mochizuki M. International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop On Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm. 2009; 17: 160–169.
Hernandez Blasco L, Sanchez Hernandez IM, Villena Garrido V, de Miguel Poch E, Nunez Delgado M, Alfaro Abreu J. Safety of the transbronchial biopsy in outpatients. Chest. 1991; 99: 562–565.
Hibberd C, Yau JL, Seckl JR. Glucocorticoids and the ageing hippocampus. J Anat. 2000; 197: 553–562.
Hillerdal G, Nou E, Osterman K, Schmekel B. Sarcoidosis: epidemiology and prognosis. A 15-year European study. Am Rev Respir Dis. 1984; 130: 29–32.
Hunninghake GW, Costabel U, Ando M, Baughman R, Cordier JF, du Bois R, Eklund A, Kitaichi M, Lynch J, Rizzato G, Rose C, Selroos O, Semenzato G, Sharma OP. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders. Sarcoidosis Vasc Diffuse Lung Dis. 1999; 16: 149–173.
Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007; 357: 2153–2165.
Judson MA, Thompson BW, Rabin DL, Steimel J, Knattereud GL, Lackland DT, Rose C, Rand CS, Baughman RP, Teirstein AS. The diagnostic pathway to sarcoidosis. Chest. 2003; 123: 406–412.
Kaiser PK, Lowder CY, Sullivan P, Sanislo SR, Kosmorsky GS, Meziane MA, Rice TW, Smith SD, Meisler DM. Chest computerized tomography in the evaluation of uveitis in elderly women. Am J Ophthalmol. 2002; 133: 499–505.
Lenner R, Schilero GJ, Padilla ML, Teirstein AS. Sarcoidosis presenting in patients older than 50 years. Sarcoidosis Vasc Diffuse Lung Dis. 2002; 19: 143–147.
Mayock RL, Bertrand P, Morrison CE, Scott JH. Manifestations of sarcoidosis. Analysis of 145 patients, with a review of nine series selected from the literature. Am J Med. 1963; 35: 67–89.
Morimoto T, Azuma A, Abe S, Usuki J, Kudoh S, Sugisaki K, Oritsu M, Nukiwa T. Epidemiology of sarcoidosis in Japan. Eur Respir J. 2008; 31: 372–379.
Neville E, Walker AN, James DG. Prognostic factors predicting the outcome of sarcoidosis: an analysis of 818 patients. Q J Med. 1983; 52: 525–533.
Reynolds HY. Sarcoidosis: impact of other illnesses on the presentation and management of multi-organ disease. Lung. 2002; 180: 281–299.
Rybicki BA, Major M, Popovich J Jr, Maliarik MJ, Iannuzzi MC. Racial differences in sarcoidosis incidence: a 5-year study in a health maintenance organization. Am J Epidemiol. 1997; 145: 234–241.
Sharma OP. Sarcoidosis in the aged. Geriatrics. 1973; 28: 76–85.
Siltzbach LE, James DG, Neville E, Turiaf J, Battesti JP, Sharma OP, Hosoda Y, Mikami R, Odaka M. Course and prognosis of sarcoidosis around the world. Am J Med. 1974; 57: 847–852.
Souverein PC, Berard A, Van Staa TP, Cooper C, Egberts AC, Leufkens HG, Walker BR. Use of oral glucocorticoids and risk of cardiovascular and cerebrovascular disease in a population based case-control study. Heart. 2004; 90: 859–865.
Stadnyk AN, Rubinstein I, Grossman RF, Baum GL, Hiss Y, Solomon A, Rosenthal T. Clinical features of sarcoidosis in elderly patients. Sarcoidosis. 1988; 5: 121–123.
Tachibana T, Iwai K, Takemura T. Sarcoidosis in the aged: review and management. Curr Opin Pulm Med. 2010; 16: 465–471.
Wasfi YS, Rose CS, Murphy JR, Silveira LJ, Grutters JC, Inoue Y, Judson MA, Maier LA. A new tool to assess sarcoidosis severity. Chest. 2006; 129: 1234–1245.
Watters LC, King TE, Schwarz MI, Waldron JA, Stanford RE, Cherniack RM. A clinical, radiographic, and physiologic scoring system for the longitudinal assessment of patients with idiopathic pulmonary fibrosis. Am Rev Respir Dis. 1986; 133: 97–103.
Yanardag H, Pamuk ON. Older sarcoidosis patients: experience of a medical center in Turkey. South Med J. 2004; 97: 472–474.
المشرفين على المادة: 0 (Immunosuppressive Agents)
تواريخ الأحداث: Date Created: 20120501 Date Completed: 20120725 Latest Revision: 20220310
رمز التحديث: 20240628
DOI: 10.1097/MD.0b013e3182569f91
PMID: 22543629
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-5964
DOI:10.1097/MD.0b013e3182569f91