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Sarcoidosis in Turkey

Sarcoidosis in Turkey. Dr.Göksel KITER Pamukkale University, Medical Faculty Pulmonary Medicine Department. Main topics. Overview to the studies on Turkish Sarcoidosis cases “Sarcoidosis” study preformed by Turkish Thoracic Society The results obtained from that study

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Sarcoidosis in Turkey

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  1. Sarcoidosis in Turkey Dr.Göksel KITER Pamukkale University, Medical Faculty Pulmonary Medicine Department

  2. Main topics • Overview to the studies on Turkish Sarcoidosis cases • “Sarcoidosis” study preformed by Turkish Thoracic Society • The results obtained from that study • Lessons that we’ve learned in that process

  3. ACCESS • Case control study • Aimed to evaluate the etiological aspect • November 1996-June 1999 • 10 centers; 720 patients and 720 controls

  4. Turkish Sarcoidosis Case Series 1954-2000 1327 patients from 29 series 1990-2000, Istanbul Medical Faculty; 147 cases • Gürkan ÖU, Çelik G, Kumbasar Ö ve ark. Sarcoidosis in Turkey:1954-2000. Ann Saudi Med 2004 • Tabak L, Kılıçarslan Z, Kıyan E ve ark. 147 sarkoidoz hastasının klinik özellikleri. Solunum 2001 • Sağlam L, Kaynar H, Akgün M ve ark. The retrospective analysis of our patients with sarcoidosis. 2001 • Aytemur ZA, Erdinç M, Erdinç E, ve ark. Sarkoidozda evrelere göre klinik özellikler ve tanısal yaklaşım. Tüberküloz ve Toraks 2003 • Yalnız E, Kömürcüoğlu A, Polat GE, ve ark. Sarkoidozda klinik, radyolojik, laboratuarla ilgili parametreler ve tanı yöntemleri. Toraks Dergisi 2003 • Erbaycu AE, Uçar ZZ, Çakan A, ve ark. Seasonal clustering of sarcoidosis in spring in Turkey. Turkish Respiratory Journal, 2004. • Baran A, Özşeker F, Güneylioğlu D, ve ark. Sarkoidoz: Yedi yıllık deneyim. Toraks Dergisi 2004 • Demirkök SS, Başaranoğlu M, Akıncı ED, Karayel T. Analysis of 275 patients with sarcoidosis over a 38 year period; a single-instutition experience. Respiratory Medicine 2006 1991-2002, Erzurum, Atatürk University; 25 cases 1990-1998, Izmir, Ege University; 77 cases 1995-2001, Izmir Chest Hospital; 73 cases 1994-2003, Izmir Chest hospital; 86 cases 1994-2000, Istanbul Sureyyapasa Chest Hospital; 70 cases 1966-2004, Istanbul Cerrahpasa Medical Faculty; 275 cases

  5. Turkish Thoracic Society Clinical Problems Working Group “Sarcoidosis” study

  6. Aim of the study • To find-out the epidemiological features of sarcoidosis in Turkey • To evaluate the pulmonary involvement • To evaluate the utility of diagnostic approachs • To assess the extra-pulmonary involvement • To make a comment on geographical disturbance

  7. 1 June 2004 – 31 May 2006 • 12 cities, 19 centers, 24 colleagues • 293 new patients

  8. 4,6 5,0 2,8 6,8 10,6 9,1 4,2 2,6 7,0 0,9 3,1 Incidence 4 in 100 000

  9. Female / Male = 2,08 Mean age: 44 ± 13 1 in 3 cases was above 50 age

  10. ♀Mean 47 ± 13 ♂ Mean 37 ± 12 p<0,001

  11. Smoking history

  12. Symptoms

  13. Radiological stage

  14. PFT was performed in 257 patients, CO diffusion test was performed in 161 patients

  15. Gurkan OU, Celik G, Kumbasar O et al. Sarcoidosis in Turkey:1954-2000. Ann Saudi Med 2004

  16. BALF analyses In 79 sarcoidosis patients (26.9%) • Lymphocytic plus neutrofilic alveolitis 46.8% • Lone lymphocytic alveolitis 34.2% • Lone neutrophilic alveolitis 5.1% • Mixt alveolitis 5.1% • No alveolitis 8.9% • Only Neutrophilic plus lymphositic alveolitis was found associated with only being recently active smoker (p=0.03).

  17. Demirkök SS, Başaranoğlu M, Akıncı ED, Karayel T. Analysis of 275 patients with sarcoidosis over a 38 year period; a single-instutition experience. Respiratory Medicine 2006

  18. * More in above age 40

  19. GEOGRAPHIC DIFFERENCES Older patients were mostly living at sea-side cities; p=0,006

  20. Conclusion • Turkish sarcoidosis cases, especially females, were older than the literature. Female/male=2 • Smokers were in 20%; similar to published data • Pulmonary symptoms were frequent (Cough the most) • Constitutional symptoms in half of the patients (fever the most) • Lower eye and neurological involvement ratios • Elderly patients in the areas near to the sea • Histopathological confirmation rate was high (%90,4); bronchoscopy was yielded in half of the patients, mediastinoscopy was used not very rarely.

  21. LESSONS WE’VE LEARNED • It should be forced to include patients representing all geographic areas. • All physicians should be attend to the study. • 2.5 fold attendence to ILD study. • Internet is a useful tool. • Method must be described more precisely. • That study design is worked very-well. Valuable epidemiologic data have been obtained. • A data base has been created for further studies on treatment and follow-up.

  22. Thank you

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