Course and prognosis of sarcoidosis in a referral setting in Turkey; analysis of 166 patients.

Background: Clinical manifestations and prognosis of sarcoidosis are heterogenous and the prevalence varies depending on the country, area and race evaluated. Also the organs involved and courses of the disease differ greatly between countries, areas, races and individuals.

Aims: To investigate the sociodemographic characteristics, clinical presentation and symptoms and to determine the severity and prognosis of sarcoidosis in Turkey as a referral center.

Methods: Between January and July 2003 we retrospectively evaluated the outcome of the patients with sarcoidosis whose first clinical visits were between 1965 and 2003 in the multidisciplinary referral setting RS at Cerrahpasa Medical Faculty of the University of Istanbul. Data collected about each patient included sociodemographic characteristics, clinical presentation, symptoms, date of diagnosis, date and age of onset, method and stage of disease at the date of diagnosis and at the date of last evaluation; the mortality and survival rate were calculated. One hundred and sixty six consecutive patients whose first clinical visits were between 1965 and 2003 in the multidisciplinary RS at Cerrahpasa Medical Faculty were enrolled. We contacted every patient in our cohort by telephone calls or home visits. All those contacted were called back to outpatient clinic for a formal evaluation between June and September 2003. A formal physical examination and thorax radiography were performed in patients who came to the hospital. Their radiological stage, signs, symptoms and associated extrapulmonary manifestations were recorded.

Results: At the initial presentation, the mean age of diagnosis was 40.3 years. The 31-40 age group is the group with the highest number of patients. Coughing was the most frequent symptom and erythema nodosum was the most frequent sign in both sexes. Thirty eight percent of patients had extrathoracic involvement. The most frequent extrapulmonary site of involvement was skin. The mortality rate was 11.6% (10.8% in females and 13% in males). Comorbidity was 3% (5 females, 1 male). Females, youngs and patients without extrathoracic involvement had higher survival rates.

Conclusion: Clinical characteristics, course and prognosis of sarcoidosis vary in different studies. The results may vary accordingly to ethnic, geographic, social and economic conditions.