Characteristics of population of patients with sarcoidiosis in the republic of Tatarstan: the results of multi-year monitoring

Abstract

Sarcoidosis is a systemic epithelioid cell granulomatous disease of unknown etiology, which prevalence has increased over the past three decades. The objective of this work was to analyse the register of patients with sarcoidosis, in which the patients from the Republic of Tatarstan were entered for the period from 1969 until now. Methods. A patient database was created and processed using the SPSS18 program with the calculation of frequencies, means, errors of the mean and confidence interval. The authors analysed the data at the time of detection of sarcoidosis. Results. A total of 2477 patients (69.9% of women) aged from 15 to 87 years old (44.04 ± 0.26 (12.9) years) were entered in the register. There were 28.7% under the age of 35, 51.6% were 36–55, and 19.8% were older than 55 years. Radiation stages were distributed as follows: 0 - 0.9%, I - 42.6%, II - 46.2%, III - 9.4% and IV - 0.8%. 13.1% of newly diagnosed patients had a Lofgren’s syndrome. Histological verification was carried out in 40.9% of cases. 31.4% of patients were affected by occupational or environmental factors that might negatively influence their health. The number of new cases of sarcoidosis in Tatarstan began to grow from 1995 (50 new cases) with a peak in 2016 (141 cases), which corresponds to the opinion of leading international experts on sarcoidosis, who reported an increase in the incidence rate over the last three decades. The proportion of verified patients in these years varied around 50%, reaching a maximum of 60.5% in 2012. Out of the total number of 1014 verified cases, 62.8% validated the diagnosis in oncological institutions, 25.2% in multidisciplinary institutions, 8.0% in phthisiological institutions, and 1 case at autopsy. Histological material (video-assisted thoracoscopy) was obtained in 75.1% of cases, and aspirate obtained during bronchoscopy was used in 24.9% of cases. Active monitoring was the most commonly used disease management (37.3%), vitamin E was used in 23.4%, vitamin E and pentoxifylline in 21.2%, systemic glucocorticosteroids were used in 14.9%, methotrexate was used in 1.7%, inhaled steroids in 1.3%, antibiotics in 0.2%, azathioprine in 0.1% and N-acetylcysteine was used in 1 patient. Conclusion. In Tatarstan, verified cases did not exceed half of cases against the background of increased detection of patients with sarcoidosis and the availability of skilled care. Patient management was consistent with modern international guidelines.

Keywords

• sarcoidosis
• register
• diagnosis
• radiation stages
• treatment