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    Analysis of 275 patients with sarcoidosis over a 38 year period; a single-institution experience
    (W B SAUNDERS CO LTD, 2007) Demirkök, Sevtap Sipahi; Başaranoğlu, Metin; Akıncı, Eylem Deniz; Karayel, Tuncer
    Background: Sarcoidosis is a systemic granulomatous disease with unknown etiology. Objectives: We evaluated seasonal variation, demographic, clinical and diagnostic features of sarcoidosis in recently diagnosed symptomatic patients in the whole cohort (275 patients) and in the subgroups according to the estimated disease course (subacute course group vs. chronic course group). We also developed a prediction model to predict the course of sarcoidosis using simple clinical and demographic variables. Material and methods: Two hundred and seventy-five patients with sarcoidosis. Measurements and statistics: Roger's test, chi-square, t-test and multiple logistic regression were used. Results: The distribution of cumulative monthly diagnosis was the lowest in November (fall) (p < 0.01). Seasonal pattern was influenced by age and gender. Constitutional symptoms, stages 2 and 3 diseases and the absence of erythema nodosum were highly significant parameters for chronic course. Using these variables, the developed model had a specificity of 93.1 % and its positive predictive value was 89.5%. Progression of the disease was documented 6.4% in subacute group vs. 32.1% in chronic group (p=0.00001). Preventive effect of smoking was more pronounced in females than in mates in our cohort. Conclusions: Further well-designed and large prospective studies are required to better understand the importance of these findings, and to validate the prediction model presented here. (c) 2006 Elsevier Ltd. All rights reserved.
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    Analysis of 87 Patients With Lofgren's Syndrome and the Pattern of Seasonality of Subacute Sarcoidosis
    (Wiley, 2006) Demirkök, Sevtap Sipahi; Başaranoğlu, Metin; Derviş, Emine; Bal, Mert; Karayel, Tuncer
    Background: Sarcoidosis is a multisystem disease of unknown aetiology. The seasonality of sarcoidosis in symptomatic, recently diagnosed patients with Lofgren's syndrome was evaluated to help better understand the possible causative factor(s) in the pathogenesis of sarcoidosis. Methods: Four hundred and ninety-two consecutive patients with sarcoidosis were investigated. The demographic and clinical features, course of the disease, initial diagnostic methods and both the month and age at initial diagnosis for each patient were analysed. Roger's test for cyclic variation was used to determine the significance of any seasonal variation of incidence. Results: Lofgren's syndrome was diagnosed in 87 patients (18%). The diagnosis of sarcoidosis was delayed in 45% of subjects (mean: 11.2 weeks). The distribution of cumulative monthly presentations peaked in May (spring) and was the lowest in January (winter) and November (autumn) (P < 0.001). The seasonal pattern was also influenced by age and gender (P < 0.05). At the onset, arthralgia was present in 46%, cough or dyspnoea in 37%, constitutional symptoms in 32% and skin lesions in 30% of the patients. Conclusions: In this study, there were differences in the amplitude of the seasonal variation by age and by gender. Well-designed prospective studies are required to better understand the importance of the findings we respect to the pathogenesis of the disease.
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    Seasonality of the onset of symptoms, Tuberculin test anergy and Kveim positive reaction in a large cohort of patients with sarcoidosis
    (WILEY, 2007) Demirkok, Sevtap Sipahi; Basaranoglu, Metin; Coker, Elif; Karayel, Tuncer
    Background and objectives: Sarcoidosis is a systemic granulomatous disease of unknown aetiology and pathogenesis. This study evaluated the seasonal variation in the onset of symptoms, Tuberculin anergy and Kveim positive reaction in a cohort of 492 patients with sarcoidosis and in a subgroup of 248 patients with known Kveim test responses. Methods: The medical records of 492 patients with sarcoidosis were retrospectively reviewed. Roger's test for cyclic variation was used to assess the statistical significance of the observed seasonal variation. Results: For all sarcoidosis patients (n = 492) the onset of symptoms was most frequent in spring (61.8%) and least frequent in summer (31.7%) (P < 0.001). For patients with Tuberculin anergy (n = 364) the onset of symptoms was most frequent in spring and least frequent in autumn (P < 0.001); there was no seasonal variation among Tuberculin positive patients (n = 128). Of those patients with a Kveim test result (n = 248), the onset of symptoms was most frequent in spring and least frequent in summer (P < 0.001); there was no seasonal variation for patients with a negative Kveim results (n = 50 patients). Conclusions: The onset of the symptoms was most frequent in spring and least frequent in the second half of the year (summer or autumn) in patients with sarcoidosis, Tuberculin anergy and a positive Kveim reaction. The significance of this finding in relation to aetiology and clinical utility needs to be further assessed.