2011 OPEN FORUM Abstracts
GENDER DIFFERENCES IN THE CLINICAL PRESENTATION OF SARCOIDOSIS IN ESTONIA.
Hille Lill, Kai Kliiman, Alan Altraja; Tartu University Lung Clinic, Tartu, Estonia
Background: Sarcoidosis is prevalent in Northern European Countries including Estonia, but variation of its clinical presentation has not been sufficiently studied. Therefore, we currently analyzed gender variations in the Estonian sarcoidosis patients . Methods: All patients with a clinical-pathological diagnosis of sarcoidosis were recruited from the Tartu University Lung Clinic between February 2009 and April 2011 using their clinical records. The type of onset (acute vs. non-acute), the radiological stage, the clinician-estimated need to treat, the serum angiotensin converting enzyme (ACE) and Ca2+ levels were compared between male and female patients using Spearman's Chi-square test or Mantel-Haenszel test. Results: A total of 233 cases were included, significantly more females (135, 57.9%) than males (98, 42.1%) (p=0.0006). Acute vs. non-acute onset was found in 45 (33.3%) vs. 90 (66.6%) women and in 26 (26.5%) vs. 72 (73.4%) men, respectively, without a significant between-gender difference. Hypercalcemia (< 1.29 mmol/L) was found in overall 72 cases (30.9%) and was significantly more prevalent in males than females (p=0.005). An increased serum ACE content (< 52 U/L) was present in overall 109 cases (46.8%), in 52 (38.5%) females (20 acute, 32 non-acute) and in 57 (58.1%) males (16 acute, 41 non-acute). Men presented significantly more often with an increased serum ACE content (p=0.003), but no difference was found between males and females for acute/non-acute onset. A total of 199 (85.4%) cases were diagnosed at radiological stages 1 (43 cases, 27 women, 16 men) and 2 (156 cases, 84 women, 72 men). Only 24 (10.3%) patients had a radiological pattern of either stage 3 or 4. No visible thoracic findings (stage 0) were described in 10 cases (4.3%). There were no differences between the genders either for the summarized radiological presentation or for any of the particular stage. A total of 140 patients (60.1%) were needed for treatment, 86 (63.7%) women and 54 (55.1%) men without a significant between-gender difference. Conclusion: Not surprisingly, women were more likely to have sarcoidosis. But in our cohort, men have more frequently abnormalities of calcium metabolism and increased serum ACE level than women. The type of the onset, as well as the radiological stage of sarcoidosis, is similarly distributed among the genders in Estonia.
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