دورية أكاديمية
Late-onset sarcoidosis: a comparative study.
العنوان: | Late-onset sarcoidosis: a comparative study. |
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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. |
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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 |
تدمد: | 1536-5964 |
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DOI: | 10.1097/MD.0b013e3182569f91 |