Semin Respir Crit Care Med 2017; 38(04): 393-403
DOI: 10.1055/s-0037-1602845
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sarcoidosis around the Globe

Kondwelani Mateyo1, 2, Michiel Thomeer3, 4
  • 1Respiratory Unit, Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
  • 2Center of Interstitial Lung Diseases, St. Antonius Hospital, Nieuwegein, The Netherlands
  • 3Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
  • 4Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium
Further Information

Publication History

Publication Date:
27 July 2017 (online)

Abstract

Despite sarcoidosis having a worldwide occurrence, the epidemiological map still has gaps. Prevalence and incidence rates-inconsistences have been mainly due to a lack of uniformity in study definitions as well as data collection methods. Nonetheless, studies have been consistent in showing high prevalence and incidence in Scandinavian and African American populations. Data from racially diverse populations have consistently revealed highest incidence in people of African descent. Within populations, geographical (north-to-south gradient) and time clusters have also been demonstrated from place to place. Of great interest but still elusive to researchers is the cause of sarcoidosis. The most recent focus has mostly been on Mycobacteria species and Propionibacterium acnes, but results of research thus far have been less than outright and in some cases conflicting. Environmental exposures to such substances as mold and mildew and occupations such as agricultural employment, health care work, and firefighting have been widely cited as risk factors for diseases. Certain genotypes have been linked to sarcoidosis with familial and racial clusters apparent. Some disease phenotypes have also been linked to particular genes, leaving room for further genetic research. Sarcoidosis causes multisystemic morbidity, with pulmonary, cardiac, and neurological involvement carrying the worst prognosis. Disease phenotypes vary with ethnicity, suggesting a genetic predisposition; erythema nodosum is more common in Caucasian patients, cardiac manifestations in Japanese patients, and other extrathoracic disease in black patients.