Article Text

PDF
SAT0706 End-stage organ failure in sarcoidosis: characterization and predictive factors in 1082 patients
  1. R Pérez-Alvarez1,
  2. B Kostov2,
  3. A García González3,
  4. R Gόmez De La Torre4,
  5. M Lopez Dupla5,
  6. B De Escalante6,
  7. A Alguacil7,
  8. J Chara8,
  9. J Velilla9,
  10. J Rascόn10,
  11. JS Garcia Morillo11,
  12. C Feijoo12,
  13. E Fonseca13,
  14. M Bonet14,
  15. JL Callejas15,
  16. G de la Red16,
  17. AB Madroñero Vuelta17,
  18. C Soler18,
  19. E Peral19,
  20. JF Gόmez Cerezo20,
  21. G Cruz21,
  22. P Perez22,
  23. S Fernández Rodríguez23,
  24. B Pinilla24,
  25. A Gato25,
  26. M Akasbi26,
  27. A Robles27,
  28. I Ojeda28,
  29. MJ Vives29,
  30. C Morcillo30,
  31. M Penadés31,
  32. M De Vicente32,
  33. M Ramos-Casals33,
  34. L Pallarés10,
  35. P Brito-Zerόn30,33,
  36. on behalf of the SARCOGEAS-SEMI Registry
  1. 1Hosp Alvaro Cunqueiro, Vigo
  2. 2IDIBAPS, Barcelona
  3. 3Hosp Ramόn y Cajal, Madrid
  4. 4HUCA, Oviedo
  5. 5Hosp Joan XXIII, Tarragona
  6. 6Hosp Clínico, Zaragoza
  7. 7Hosp Virgen de la Salud, Toledo
  8. 8Hosp Josep Trueta, Girona
  9. 9Hosp Miguel Servet, Zaragoza
  10. 10Hosp Son Espases, Palma de Mallorca
  11. 11Hosp Virgen del Rocio, Sevilla
  12. 12Hosp Parc Taulí, Sabadell
  13. 13Hosp de Cabueñes, Gijόn
  14. 14Althaia, Manresa
  15. 15Hosp Clínico San Cecilio, Granada
  16. 16Hosp Esperit Sant, Santa Coloma
  17. 17Hosp San Jorge, Huesca
  18. 18Hosp de Sta Caterina, Girona
  19. 19Hosp Virgen Macarena, Sevilla
  20. 20Hosp Infanta Sofía, Madrid
  21. 21Hosp de Poniente, Almería
  22. 22Hosp Puerta del Mar, Cádiz
  23. 23Hosp da Barbanza, A Coruña
  24. 24Hosp Gregorio Marañόn, Madrid
  25. 25CH, Albacete
  26. 26Hosp Infanta Leonor
  27. 27Hosp la Paz, Madrid
  28. 28Hosp Valle del Guadiato, Cόrdoba
  29. 29San Joan de Déu, San Boi
  30. 30Hosp CIMA-Sanitas, Barcelona
  31. 31Hosp de Manises, Valencia
  32. 32Hosp Nuestra Señora del Prado, Talavera
  33. 33Hosp Clínic, Barcelona, Spain

Abstract

Objectives To characterize the main features at presentation of sarcoidosis associated with the development of end-stage organ failure in a large multicenter cohort of patients from Southern Europe.

Methods In January 2017, the Spanish National Registry of Sarcoidosis (SARCOGEAS-SEMI) included 1082 consecutive patients diagnosed with sarcoidosis according to the ATS/ERS/WASOG 1999 statement and extrathoracic involvement to the 2014 WASOG instrument. The development of end-stage organ failure was assessed at the last visit.

Results The cohort consisted of 618 (57%) women and 464 (43%) men, with a mean age at diagnosis of 47yrs. After a mean follow-up of 82 months, 90 (8%) patients developed end-stage organ failure, including respiratory failure (n=56), chronic renal failure (n=13), cardiac failure/permanent cardiac device (n=8) and liver cirrhosis (n=3). The following baseline features were associated with end-stage organ failure in the univariate analysis: patients born in Spain (p=0.008), a higher mean age at diagnosis (p<0.001) and a radiological stage III/IV (p<0.001) With respect to extrathoracic involvement, spleen (p=0.015), renal (p=0.001), cardiac (p=0.028) and bone marrow (p=0.003) involvements, hypercalcemia (p=0.018) and use of corticosteroids (p<0.001) were associated with end-stage organ failure, while patients with cutaneous sarcoidosis had a lower risk (p=0.029). Multivariate analysis identified age at diagnosis (OR 1.05), radiological stages III/IV (OR 3.12) and use of corticosteroids (OR 4.55) as independent variables associated with the development of end-stage organ failure.

Conclusions Nearly 10% of patients with sarcoidosis developed end-stage organ failure. Respiratory failure represented two thirds of cases of sarcoidosis-related organ failure, followed by renal (15% of cases) and cardiac (9%). Older patients, as well as those presenting with advanced radiological stages, had an enhanced risk of developing end-stage organ failure.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.