Organ involvement in newly diagnosed sarcoidosis patients in the Netherlands: The first large European multicentre prospective study.

Clinical presentation Diagnosis Organ involvement Organ screening Sarcoidosis Treatment indication

Journal

Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438

Informations de publication

Date de publication:
04 Apr 2024
Historique:
received: 07 07 2023
revised: 18 03 2024
accepted: 19 03 2024
medline: 7 4 2024
pubmed: 7 4 2024
entrez: 6 4 2024
Statut: aheadofprint

Résumé

Clinical presentation and prevalence of organ involvement is highly variable in sarcoidosis and depends on ethnic, genetic and geographical factors. These data are not extensively studied in a Dutch population. To determine the prevalence of organ involvement and the indication for systemic immunosuppressive therapy in newly diagnosed sarcoidosis patients in the Netherlands. Two large Dutch teaching hospitals participated in this prospective cohort study. All adult patients with newly diagnosed sarcoidosis were prospectively included and a standardized work-up was performed. Organ involvement was defined using the WASOG instrument. Between 2015 and 2020, a total of 330 patients were included, 55% were male, mean age was 46 (SD 14) years. Most of them were white (76%). Pulmonary involvement including thoracic lymph node enlargement was present in 316 patients (96%). Pulmonary parenchymal disease was present in 156 patients (47%). Ten patients (3%) had radiological signs of pulmonary fibrosis. Cutaneous sarcoidosis was present in 74 patients (23%). Routine ophthalmological screening revealed uveitis in 29 patients (12%, n = 256)). Cardiac and neurosarcoidosis were diagnosed in respectively five (2%) and six patients (2%). Renal involvement was observed in 11 (3%) patients. Hypercalcaemia and hypercalciuria were observed in 29 (10%) and 48 (26%, n = 182) patients, respectively. Hepatic involvement was found in 6 patients (2%). In 30% of the patients, systemic immunosuppressive treatment was started at diagnosis. High-risk organ involvement in sarcoidosis is uncommon at diagnosis. Indication for systemic immunosuppressive therapy was present in a minority of patients.

Sections du résumé

BACKGROUND BACKGROUND
Clinical presentation and prevalence of organ involvement is highly variable in sarcoidosis and depends on ethnic, genetic and geographical factors. These data are not extensively studied in a Dutch population.
AIM OBJECTIVE
To determine the prevalence of organ involvement and the indication for systemic immunosuppressive therapy in newly diagnosed sarcoidosis patients in the Netherlands.
METHODS METHODS
Two large Dutch teaching hospitals participated in this prospective cohort study. All adult patients with newly diagnosed sarcoidosis were prospectively included and a standardized work-up was performed. Organ involvement was defined using the WASOG instrument.
RESULTS RESULTS
Between 2015 and 2020, a total of 330 patients were included, 55% were male, mean age was 46 (SD 14) years. Most of them were white (76%). Pulmonary involvement including thoracic lymph node enlargement was present in 316 patients (96%). Pulmonary parenchymal disease was present in 156 patients (47%). Ten patients (3%) had radiological signs of pulmonary fibrosis. Cutaneous sarcoidosis was present in 74 patients (23%). Routine ophthalmological screening revealed uveitis in 29 patients (12%, n = 256)). Cardiac and neurosarcoidosis were diagnosed in respectively five (2%) and six patients (2%). Renal involvement was observed in 11 (3%) patients. Hypercalcaemia and hypercalciuria were observed in 29 (10%) and 48 (26%, n = 182) patients, respectively. Hepatic involvement was found in 6 patients (2%). In 30% of the patients, systemic immunosuppressive treatment was started at diagnosis.
CONCLUSIONS CONCLUSIONS
High-risk organ involvement in sarcoidosis is uncommon at diagnosis. Indication for systemic immunosuppressive therapy was present in a minority of patients.

Identifiants

pubmed: 38582302
pii: S0954-6111(24)00082-9
doi: 10.1016/j.rmed.2024.107608
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

107608

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest There is no conflict of interest.

Auteurs

Julie Van Woensel (J)

Department of Respiratory Medicine Zuyderland Medical Centre, Heerlen/Sittard, the Netherlands.

Bart Koopman (B)

Department of Respiratory Medicine, OLVG, Amsterdam, the Netherlands.

Mart Schiefer (M)

Department of Respiratory Medicine, ETZ, Tilburg, the Netherlands.

Coen van Kan (C)

Department of Respiratory Medicine, OLVG, Amsterdam, the Netherlands.

Marlou Janssen (M)

Department of Respiratory Medicine Zuyderland Medical Centre, Heerlen/Sittard, the Netherlands.

Sofia Ramiro (S)

Department of Rheumatology, Zuyderland Medical Centre, Heerlen, Limburg, the Netherlands; Department of Rheumatology, Leiden University Medical Centre, Leiden, Zuid-Holland, the Netherlands.

César Magro-Checa (C)

Department of Rheumatology, Zuyderland Medical Centre, Heerlen, Limburg, the Netherlands.

Robert Bm Landewé (RB)

Department of Rheumatology, Zuyderland Medical Centre, Heerlen, Limburg, the Netherlands; Amsterdam Rheumatology Centre, AMC, Amsterdam, the Netherlands.

Martijn D de Kruif (MD)

Department of Respiratory Medicine Zuyderland Medical Centre, Heerlen/Sittard, the Netherlands.

Paul Bresser (P)

Department of Respiratory Medicine, OLVG, Amsterdam, the Netherlands.

Rémy Lm Mostard (RL)

Department of Respiratory Medicine Zuyderland Medical Centre, Heerlen/Sittard, the Netherlands; Department of Respiratory Medicine, Maastricht Universal Medical Centre, Maastricht, the Netherlands. Electronic address: r.mostard@zuyderland.nl.

Classifications MeSH