Sarcoidosis in Tunisia: epidemiologic and clinical study

##plugins.themes.academic_pro.article.main##

Bechir Louzir
Jouda Cherif
Nadia Mehiri
Nozha Ben Salah
Sonia Toujani
Anissa Zouaoui
Anissa Ouadhour
Jalloul Daghfous
Majed Béji

Abstract

Background: The epidemiologic study of sarcoidosis is problematic and differing incidences across the world are reported. In Tunisia, the incidence of this affection is yet unknown. This is at least attributable to the lack of large series and the overshadowing presence of tuberculosis.
Aim: To determine presenting signs, symptoms and investigations particularities.
Methods: We report a retrospective series patients with sarcoidosis followed up in the Rabta university hospital between 1991 and 2005 and try to determine presenting signs, symptoms and investigations particularities.
Results: 131 patients (79 women and 52 men) with a median age of 47± 14 years were reviewed. They were symptomatic in 95 % of cases. Cutaneous symptoms were present at onset in 56.8 %, respiratory symptoms in 48.6 % and general symptoms in 41.6 %.
Thoracic presentation was observed in 81.3%. Chest X-ray changes and tomodensitometry showed that type II and III were predominant.
Lung function was disturbed in 58.5% of the cases. Extrathoracic involvement, observed in 89.3 % of the cases, was largely dominated by cutaneous lesions. Histopathological lesions provided diagnosis in 66.6%.
Conclusion: The relative high frequency of dermatological lesions suggests genetic or even environmental predisposition to develop sarcoidosis such as sunlight exposition.

Keywords:

Sarcoidosis, Tuberculosis, Granulomatosis, Diagnosis, Pulmonary sarcoidosis

##plugins.themes.academic_pro.article.details##

References

  1. Gideon N M, Mannino D M. Sarcoidosis mortality in the United States, 1979-1991: An analysis of multiple-cause mortality data. Am J Med 1996; 100:423-27.
  2. Valeyre D. Sarcoïdose (1ère partie). Ann Med Interne 2001;152:58- 69.
  3. Wirnsberger R M, Vries J, Breteler MHM et al. Evaluation of quality of life in sarcoidosis patients. Respir Med 1998;92:750-56.
  4. Hart LA, Conron M, Bois RM. Sarcoidosis. Int J Tuercl Lung Dis 2001 5:791-806.
  5. Rybicki BA, Major M, Popovich J et al. Racial differences in sarcoidosis incidence: a 5 year study in a health maintenance organization. Am J Epidemiol 1998;148:234-41.
  6. Baugham R P, Teirstein A S, Judson MA et al. Clinical characteristics of patients in a case control study of sarciodosis. Am J Respir Crit Care Med 2001.164:1885-9.
  7. Matsuo T, Fujiwara N, Nakata Y. First presenting signs or symptoms of sarcoidosis in a Japanese population. Jpn J Ophthalmol. 2005;49:149-52.
  8. Brennan N J, Crean JP, Long J P et al. High prevalence of familial sarcoidosis in an Irish population. Thorax 1984;39:14-18.
  9. Demedts M, Wells A H, Anto J M et al. Interstitial lung diseases: an epidemiological overview. Eur Respir J 2001;18:2-16.
  10. Costabel U, Hunninghake G W. ATS/ERS/WASOG Statement on sarcoidosis. Am J Respir Crit Care Med 1999;160:736-55.
  11. Battesti J P, Azoulay E. Formes atypiques de la sarcoïdose. Ann Med Interne 2001;152 :51-57.
  12. Behbehani N, JayKrishnan B, Khadadah M, Hawa H, Farah Y. Clinical presentation of sarcoidosis in a mixed population in the Middle East. Respir med 2007;1016:06-025.
  13. Mangiapan G, Cadranel J. Sarcoidose. Rev Prat (Paris) 1996;1651- 58.
  14. Brauner M, Attali P, Dumas JL et al. Apport de l'imagerie dans la sarcoïdose. Ann Med Interne 2001;152:39-44.
  15. Brauner M, Grenier P, Monpoint D et al. Pulmonary sarcoidosis: Evaluation with high resolution CT. Radiology 1989;172:467-71.
  16. Costabel U. Sarcoidosis: Clinical update. Eur Respir J 2001; 1856- 68.
  17. Baughman R P, Teirstein A S, Judson M A et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001;164:1885-89.
  18. Costabel U. CD4/CD8 ratios in bronchoalveolar lavage fluid: value for diagnosing sarcoïdosis? Eur Respir J 1997;10:2699-700.
  19. Faure M. Manifestation cutanées de la sarcoïdose. Rev Prat (Paris) 1994;44:2038-41.
  20. Fortune O, Baughaman R P. The implications of BAL positive but biopsy negative sarcoidosis. Chest 2000;118:112-13.