Sarcoidosis in Iceland : A nationwide study of epidemiology, clinical picture and environmental exposure

• Published in: ERJ Open Research
• Main Authors: Haraldsdóttir, Sigríður Ólína, Jonasson, Jon Gunnlaugur, Jorundsdottir, Kristin Bara, Hannesson, Haraldur Jon, Gislason, Thorarinn, Gudbjornsson, Bjorn
• Other Authors: Faculty of Medicine, Clinical Laboratory Services, Diagnostics and Blood Bank, Internal Medicine and Emergency Services, Landspitali - The National University Hospital of Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2021
• Subjects: Lungnalæknisfræði; Meinafræði; Svefnrannsóknir; Gigtarlæknisfræði; Sarklíki; sarcoidosis; environmental exposure; Iceland; Pulmonary and Respiratory Medicine
• Online Access: https://hdl.handle.net/20.500.11815/3136; https://doi.org/10.1183/23120541.00550-2021

Funding Information: Support statement: The Icelandic Bioethics Committee (VSN 99-069-V1-V2-S1) and the Icelandic Data Protection Authority (99080306) approved the study protocol. It was supported by grants from The Science Fund of Landspitali, University Hospital of Iceland, and from the Association of Icelandic Pulmonologists. Publisher Copyright: © The authors 2021. Background This nationwide study aimed to elucidate the incidence and clinical characteristics of tissueverified sarcoidosis in Iceland. A secondary aim was to analyse sex differences and identify possible environmental factors contributing to the pathological process. Materials and methods This is a descriptive study covering 36 years ( January 1, 1981 through December 31, 2016). Histopathological reports and electronic hospital discharge registries were reviewed in context for granulomas and/or sarcoidosis. National data were used for comparison regarding smoking habits and occupation, adjusted for age, sex and year of diagnosis. The data were stored in FileMaker and calculations were made by extracting data from this database to the statistical software package R. Results A total of 418 patients (54% females) were diagnosed with tissue-verified sarcoidosis. The incidence rate was 4.15/100 000/year, similar among females and males. The mean age at diagnosis was higher among females (53.0±14.2 years) than males (48.2±13.8 years). Fatigue was the most frequent single symptom (49.7%), but when all respiratory symptoms were grouped, they were the most frequent symptoms (60%). No significant difference was found between smoking status and sarcoidosis. Possible hazardous exposure in the workplace was reported by 19.4% of the cases. Conclusion The incidence of sarcoidosis in Iceland was higher than in an Asian population where the same inclusion criteria were applied. The clinical picture diverges partly from that in the Asian population but resembles that among other Caucasians. Fatigue and respiratory symptoms were predominant. The biphasic pattern ...