title: Immune-mediated and chronic inflammatory disease in people with sarcoidosis: disease associations in a large UK database.
abstract: BACKGROUND
  Sarcoidosis is a multi-system disorder characterised by non-caseating granulomas. Coexistence of sarcoidosis with immune-mediated and chronic inflammatory diseases has been described in case series. However, the coexistence of two different diseases in individuals can occur by chance, even if each of the diseases is rare.
  
  
  OBJECTIVE
  To determine whether sarcoidosis necessitating hospital admission or day-case care coexists with a range of immune-mediated and chronic inflammatory diseases more commonly than expected by chance.
  
  
  METHODS
  Analysis of an epidemiological database of hospital admission and day-case statistics, spanning 30 years.
  
  
  RESULTS
  1510 patients with sarcoidosis were identified (mean age 44 years, median follow-up 19 years) who had been admitted to hospital or day-case care. Significant associations in the sarcoidosis cohort were identified with systemic lupus erythematosus (odds ratio (OR) 8.3; 95% CI 2.7 to 19.4), autoimmune chronic hepatitis (OR 6.7; 95% CI 1.8 to 17.1), multiple sclerosis (OR 3.3; 95% CI 1.7 to 5.6), coeliac disease (OR 3.1; 95% CI 1.01 to 7.3), thyrotoxicosis (OR 2.5; 95% CI 1.4 to 4.0), myxoedema (OR 2.2; 95% CI 1.2 to 3.7) and ulcerative colitis (OR 2.1; 95% CI 1.1 to 3.7). Weaker associations were found for diabetes mellitus with a first admission aged 30-49 years (OR 2.9; 95% CI 2.1 to 4.0) or age >50 (OR 1.7; 95% CI 1.2 to 2.3), but not for people age <30. No significant association with Crohn's disease (OR 1.52; 95% CI 0.61 to 3.14) or primary biliary cirrhosis (OR 3.75; 95% CI 0.77 to 11.0),was found. When all immune-mediated and chronic inflammatory diseases for which associations were sought were combined, the overall rate ratio associated with sarcoidosis was 2.2 (95% CI 1.9 to 2.6).
  
  
  CONCLUSIONS
  This study adds epidemiological evidence to information from clinical reports that there is a connection between sarcoidosis and other immune-mediated and chronic inflammatory diseases.
authors.affiliation: John Radcliffe Hospital, Oxford, UK.
authors.forename: N
authors.initials: N
authors.lastname: Rajoriya
authors.forename: C J
authors.initials: CJ
authors.lastname: Wotton
authors.forename: D G R
authors.initials: DG
authors.lastname: Yeates
authors.forename: S P L
authors.initials: SP
authors.lastname: Travis
authors.forename: M J
authors.initials: MJ
authors.lastname: Goldacre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D003631:Day Care, Medical; D006760:Hospitalization; D006801:Humans; D007154:Immune System Diseases / Q000150:complications* / Q000453:epidemiology; D007223:Infant; D007249:Inflammation / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications* / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult