Elderly sarcoidosis: A comparative study from a 42-year single-centre experience. (June 2019)

• Record Type: Journal Article
• Authors: Rubio-Rivas, Manuel; Corbella, Xavier; Mañá, Juan
• Is Part Of: Respiratory medicine. Volume 152(2019)
• Page Start: 1
• Page End: 6
• Publication Date: 2019-06
• Subjects: Sarcoidosis -- Elderly -- Prognosis; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2019.03.013
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Objectives: To describe the clinical features and outcomes in elderly patients with sarcoidosis and to compare them with younger patients. Material and methods: Retrospective study of a large cohort of 668 consecutive patients with sarcoidosis prospectively collected during 42 years at the Bellvitge University Hospital, a tertiary care single-centre in Barcelona, Spain. Elderly sarcoidosis was defined as sarcoidosis diagnosed in patients ≥65 years-old. Results: Elderly sarcoidosis was diagnosed in 47 (7%) patients. In younger patients, Löfgren's syndrome was the predominant mode of onset (8.5% vs. 42.2%, p < 0.001). At diagnosis, elderly patients more frequently demonstrated radiographic stage III and IV sarcoidosis (21.3% vs. 7.6%, p = 0.001), isolated extrapulmonary involvement (21.3% vs. 8.2%, p = 0.003), subcutaneous nodules (17% vs. 3.4%, p < 0.001) and intraabdominal/retroperitoneal lymph nodes (23.4% vs. 9.5%, p = 0.003). Furthermore, patients with elderly sarcoidosis achieved remission (spontaneous and under treatment) less frequently during the follow-up period (14 patients, 35% vs. 305 patients, 53%, p = 0.027) and had a higher incidence of pulmonary fibrosis (15% vs. 6.1%, p = 0.029). Death related to sarcoidosis was more prevalent in elderly patients (6.4% vs. 1.3%, p = 0.036). Conclusions: Sarcoidosis in elderly patients requires a high index of suspicion. Aged pulmonary sarcoidosis patients presented with more severe disease at presentation and worse outcomes compared to younger patients. Isolated extrapulmonary involvement at diagnosis and certain particular extrapulmonary organ involvement were more frequent in elderly sarcoidosis. Remission was less frequent in elderly sarcoidosis. Highlights: Prevalence of elderly sarcoidosis is around 7%. Löfgren's syndrome at diagnosis is less frequent in these patients. They present more often advance chest x-ray stages III and IV. Chronic sarcoidosis is more frequent in elderly sarcoidosis.