title: Epidemiologic patterns of disease expression in sarcoidosis: age, gender and ethnicity-related differences.
abstract: OBJECTIVE
  To evaluate the influence of age, gender and ethnicity in the clinical presentation of sarcoidosis in a cohort of Spanish patients.
  
  
  METHODS
  We analysed 175 consecutive patients diagnosed with sarcoidosis between 1990 and 2014 in the Hospital Clinic of Barcelona, Spain. Sarcoidosis was diagnosed according to the 1999 WASOG criteria. Organ involvement was defined using the 2014 WASOG organ assessment instrument.
  
  
  RESULTS
  There were 110 women and 65 men, with a mean age at diagnosis of 47.31 ± 15.46 years (range, 16-92); 23% of patients were born outside Spain. Women had a higher mean age (p=0.027), a higher frequency of cutaneous (OR=2.28) and musculoskeletal (OR=2.73) symptoms at diagnosis, and a lower frequency of cumulated WASOG involvements including renal involvement (OR=0.17), hypercalcaemia (OR=0.20) and raised ACE levels (OR=0.30). Patients aged ≥65 years had a lower frequency of cutaneous (OR=0.23) and musculoskeletal (OR=0.13) symptomatology at diagnosis and a higher frequency of cumulated WASOG involvements including renal involvement (OR=18.70) and calcium/vitamin D abnormalities (OR=5.31). According to ethnicity, non-Spanish-born patients had a lower mean age (40 vs. 49 years, p=0.001), a higher predominance of females (68% vs. 54%, p=0.036) and a higher frequency of radiographic stages I/II at diagnosis (97% vs. 78%, p=0.041) in comparison with Spanish-born patients.
  
  
  CONCLUSIONS
  Using the new 2014 WASOG organ assessment instrument, we found that epidemiological features (age at diagnosis, gender and ethnicity) play a significant role in the presentation of sarcoidosis. Variations in these epidemiological features may aid early diagnostic suspicion, the search for histopathological confirmation and the prompt introduction of the appropriate therapy.
authors.affiliation: Laboratory of Systemic Autoimmune Diseases "Josep Font", CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, Barcelona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Brito-Zerón
authors.affiliation: Department of Pneumology, ICT, Hospital Clinic, Barcelona, Spain.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Sellarés
authors.affiliation: Quick Diagnosis Unit, Department of Internal Medicine, ICMID, Hospital Clinic, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch
authors.affiliation: Department of Pneumology, ICT, Hospital Clinic, Barcelona, Spain.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Hernández
authors.affiliation: Research Group in Primary Care, IDIBAPS, ABS Les Corts, CAPSE, Barcelona, Spain.
authors.forename: Belchin
authors.initials: B
authors.lastname: Kostov
authors.affiliation: Research Group in Primary Care, IDIBAPS, ABS Les Corts, CAPSE, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sisó-Almirall
authors.affiliation: Laboratory of Systemic Autoimmune Diseases "Josep Font", CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lopez Casany
authors.affiliation: Direcció de Sistemes de la Informació, Hospital Clinic, Barcelona, Spain.
authors.forename: Josep Manel
authors.initials: JM
authors.lastname: Santos
authors.affiliation: Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Paradela
authors.affiliation: Department of Radiology, Hospital Clinic, Barcelona, Spain.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sánchez
authors.affiliation: Department of Pathology, Hospital Clinic, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Ramírez
authors.affiliation: Department of Pneumology, ICT, Hospital Clinic, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Xaubet
authors.affiliation: Department of Pneumology, ICT, Hospital Clinic, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Agustí
authors.affiliation: Laboratory of Systemic Autoimmune Diseases "Josep Font", CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, Barcelona, Spain. mramos@clinic.ub.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramos-Casals
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000097:blood / Q000175:diagnosis / Q000208:ethnology; D012720:Severity of Illness Index; D012737:Sex Factors; D012867:Skin / Q000473:pathology; D013030:Spain / Q000453:epidemiology; D063189:Symptom Assessment / Q000379:methods; D014807:Vitamin D / Q000097:blood
chemical_list: D014807:Vitamin D; D002118:Calcium