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==Overview==
==Overview==
[[Sarcoidosis]] is a worldwide disease but there are some parts of the world and some ethnic groups which [[sarcoidosis]] is more common. [[Sarcoidosis]] is not common before adulthood. It is rarely diagnosed in patients younger than 10 years. In children the clinical picture is different from adult, mostly involving eyes([[uveitis]]), skin and joints. [[Sarcoidosis]] is believed to be more common in women compared to men.


==Epidemiology==
==Epidemiology==
[[Sarcoidosis]] involves all ethnic groups over the world, but the [[incidence]] varies in different regions and/or ethnic groups<ref name="epid">Hosoda Y, Yamaguchi M, Hiraga Y: Global epidemiology of sarcoidosis. What story do prevalance and incidence tell us? Clin Chest Med 18:681–694, 1997.</ref>. The [[annual incidence]] is highest in [[Northern Europe]](5 to 40 cases per 100,000)<ref>Pietinalho A, Hiraga Y, Hosoda Y, Lofroos AB, Yamaguchi M, Selroos O. The frequency of sarcoidosis in Finland and Hokkaido, Japan: a comparative epidemiological study. Sarcoidosis 1995;12:61-67.</ref>, whereas in [[Eastern Europe]] only 3.68 cases of [[sarcoidosis]] per 100,000 are reported<ref>Kolek V: Epidemiological study on sarcoidosis in Moravia and Silesia. Sarcoidosis 11:110–112, 1994.</ref>. The global [[prevalence]] and [[incidence]] is difficult to calculate because of different diagnostic criteria and clinical heterogenicity. Many clinicians believe that the estimates of [[prevalence]] and [[incidence]] are lower than actual rates<ref>Reich JM: A critical analysis of sarcoidosis incidence assessment. Multidiscip Respir Med 8:57, 2013.</ref>.


Sarcoidosis most commonly affects young adults of both sexes, with a slight preponderance for women having been reported by most studies. Incidence is highest for individuals younger than 40 and peaks in the age-group from 20 to 29 years.<ref name="Baughman"/>
===Age===
 
* [[Sarcoidosis]] is not common before adulthood and in pediatric population it is usually diagnosed in patients older than 10 years with a peak of 13-15 year-old groups<ref>Baculard A, Blanc N, Boule M, et al: Pulmonary sarcoidosis in children: a follow-up study. Eur Respir J 17:628–635, 2001.</ref>. In children there is a different clinical picture, involving mostly eyes([[uveitis]]), joints and skin rather than lung and lung involvement is diagnosed incidentally by imaging studies<ref>Pattishall EN, Strope GL, Spinola SM, Denny FW: Childhood sarcoidosis. J Pediatr 108:169–177, 1986.</ref>. The most common finding in [[pediatric sarcoidosis]] is abnormal chest radiography<ref>Milman N, Hoffmann AL: Childhood sarcoidosis: long-term follow-up. Eur Respir J 31:592–598, 2008.</ref>.
Sarcoidosis occurs throughout the world in all races with a prevalence ranging from 1 to 40 per 100,000.
* The clinical scenario in [[juvenile-onset sarcoidosis]] is more similar to adult type<ref>Fretzayas A, Moustaki M, Vougiouka O: The puzzling clinical spectrum and course of juvenile sarcoidosis. World J Pediatr 7:103–110, 2011.</ref><ref>Shetty AK, Gedalia A: Childhood sarcoidosis: a rare but fascinating disorder. Pediatr Rheumatol Online J 6:16, 2008.</ref>.
The disease is most prevalent in Northern European countries, and the highest annual incidence of 60 per 100,000 is found in Sweden and Iceland. In the United States, sarcoidosis is more common in people of African descent than Caucasians, with annual incidence reported as 35.5 and 10.9 per 100,000, respectively.<ref name="Henke">Henke, C. E., G. Henke, L. R. Elveback, C. M. Beard, D. J. Ballard and L. T. Kurland. 1986. The epidemiology of sarcoidosis in Rochester, Minnesota: a population-based study of incidence and survival. Am. J. Epidemiol. 123:840–845.</ref> Sarcoidosis is less commonly reported in South America, Spain and India.
* In United States nearly half of the patients are older than 40 with a bimodal peaks of age of onset, 20-29 and 60-65<ref name="epid">Hosoda Y, Yamaguchi M, Hiraga Y: Global epidemiology of sarcoidosis. What story do prevalance and incidence tell us? Clin Chest Med 18:681–694, 1997.</ref><ref>Baughman RP, Teirstein AS, Judson MA, et al: Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 164:1885–1889, 2001.</ref><ref>Hillerdal G, Nou E, Osterman K, Schmekel B: Sarcoidosis: epidemiology and prognosis. A 15-year European study. Am Rev Respir Dis130:29–32, 1984.</ref>.


The differing incidence across the world may be at least partially attributable to the lack of screening programs in certain regions of the world and the overshadowing presence of other granulolomatous diseases such as [[tuberculosis]], that may interfere with the diagnosis of sarcoidosis where they are prevalent.<ref name="Baughman">Baughman RP, Lower EE, du Bois RM. Sarcoidosis. The Lancet 2003/3/29;361(9363):1111-8.</ref>
===Gender===
* [[Sarcoidosis]] is believed to be more common in women(57% of patients) compared to men<ref>Sharma OP: Sarcoidosis around the world. Clin Chest Med 29:357–363, vii, 2008.</ref>.
* Ocular and neurologic symptoms are more common in women<ref>Jones N, Mochizuki M: Sarcoidosis: epidemiology and clinical features. Ocul Immunol Inflamm 18:72–79, 2010.</ref>.


There may also be racial differences in the severity of the disease. Several studies suggest that the presentation in people of African origin may be more severe than for Caucasians, who are more likely to suffer from asymptomatic disease.<ref name="Am Thor Soc"> "American Thoracic Society: Statement on sarcoidosis. Am J Respir Crit Care Med 1999;160:736-755.</ref>
===Race===
* The annual incidence of sarcoidosis in black americans compared to white americans is 3:1<ref>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.</ref><ref name="epid">Hosoda Y, Yamaguchi M, Hiraga Y: Global epidemiology of sarcoidosis. What story do prevalance and incidence tell us? Clin Chest Med 18:681–694, 1997.</ref>.
* The prognosis is also more likely to be poor in black americans<ref>Baughman RP, Teirstein AS, Judson MA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001;164:1885-1889.</ref>.


==References==
==References==

Latest revision as of 13:37, 4 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roshan Dinparasti Saleh M.D.

Overview

Sarcoidosis is a worldwide disease but there are some parts of the world and some ethnic groups which sarcoidosis is more common. Sarcoidosis is not common before adulthood. It is rarely diagnosed in patients younger than 10 years. In children the clinical picture is different from adult, mostly involving eyes(uveitis), skin and joints. Sarcoidosis is believed to be more common in women compared to men.

Epidemiology

Sarcoidosis involves all ethnic groups over the world, but the incidence varies in different regions and/or ethnic groups[1]. The annual incidence is highest in Northern Europe(5 to 40 cases per 100,000)[2], whereas in Eastern Europe only 3.68 cases of sarcoidosis per 100,000 are reported[3]. The global prevalence and incidence is difficult to calculate because of different diagnostic criteria and clinical heterogenicity. Many clinicians believe that the estimates of prevalence and incidence are lower than actual rates[4].

Age

  • Sarcoidosis is not common before adulthood and in pediatric population it is usually diagnosed in patients older than 10 years with a peak of 13-15 year-old groups[5]. In children there is a different clinical picture, involving mostly eyes(uveitis), joints and skin rather than lung and lung involvement is diagnosed incidentally by imaging studies[6]. The most common finding in pediatric sarcoidosis is abnormal chest radiography[7].
  • The clinical scenario in juvenile-onset sarcoidosis is more similar to adult type[8][9].
  • In United States nearly half of the patients are older than 40 with a bimodal peaks of age of onset, 20-29 and 60-65[1][10][11].

Gender

  • Sarcoidosis is believed to be more common in women(57% of patients) compared to men[12].
  • Ocular and neurologic symptoms are more common in women[13].

Race

  • The annual incidence of sarcoidosis in black americans compared to white americans is 3:1[14][1].
  • The prognosis is also more likely to be poor in black americans[15].

References

  1. 1.0 1.1 1.2 Hosoda Y, Yamaguchi M, Hiraga Y: Global epidemiology of sarcoidosis. What story do prevalance and incidence tell us? Clin Chest Med 18:681–694, 1997.
  2. Pietinalho A, Hiraga Y, Hosoda Y, Lofroos AB, Yamaguchi M, Selroos O. The frequency of sarcoidosis in Finland and Hokkaido, Japan: a comparative epidemiological study. Sarcoidosis 1995;12:61-67.
  3. Kolek V: Epidemiological study on sarcoidosis in Moravia and Silesia. Sarcoidosis 11:110–112, 1994.
  4. Reich JM: A critical analysis of sarcoidosis incidence assessment. Multidiscip Respir Med 8:57, 2013.
  5. Baculard A, Blanc N, Boule M, et al: Pulmonary sarcoidosis in children: a follow-up study. Eur Respir J 17:628–635, 2001.
  6. Pattishall EN, Strope GL, Spinola SM, Denny FW: Childhood sarcoidosis. J Pediatr 108:169–177, 1986.
  7. Milman N, Hoffmann AL: Childhood sarcoidosis: long-term follow-up. Eur Respir J 31:592–598, 2008.
  8. Fretzayas A, Moustaki M, Vougiouka O: The puzzling clinical spectrum and course of juvenile sarcoidosis. World J Pediatr 7:103–110, 2011.
  9. Shetty AK, Gedalia A: Childhood sarcoidosis: a rare but fascinating disorder. Pediatr Rheumatol Online J 6:16, 2008.
  10. Baughman RP, Teirstein AS, Judson MA, et al: Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 164:1885–1889, 2001.
  11. Hillerdal G, Nou E, Osterman K, Schmekel B: Sarcoidosis: epidemiology and prognosis. A 15-year European study. Am Rev Respir Dis130:29–32, 1984.
  12. Sharma OP: Sarcoidosis around the world. Clin Chest Med 29:357–363, vii, 2008.
  13. Jones N, Mochizuki M: Sarcoidosis: epidemiology and clinical features. Ocul Immunol Inflamm 18:72–79, 2010.
  14. 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.
  15. Baughman RP, Teirstein AS, Judson MA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001;164:1885-1889.

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