Results of analysis of the sarcoidosis registry of the Republic of Tatarstan

Abstract

Sarcoidosis is a systemic epithelioid cell granulomatosis of unknown origin. The specialized commission on pulmonology of the Russian Ministry of Health recommended creating a register for sarcoidosis in the beginning of 2023. The aim of the study was to assess the main characteristics of newly identified patients with sarcoidosis according to the register created in the Republic of Tatarstan as a pilot project. Methods. Information on the newly identified patients was collected from 1996 to 2023. Statistical processing of 3,037 cases of sarcoidosis was carried out using the SPSS-18 program (IBM, USA). The p-value < 0.05 was considered statistically significant. Results. From 1 967 to 2 023, 3,037 cases of sarcoidosis were entered in the registry, including 2 094 women (68.9%) and 943 men (31.1%). The median age was 45 (34; 55) years, with 36 – 55 years of age being associated with the highest incidence. The men were much younger than the women. There was an increase in detection in 2017 (161 patients) with a subsequent decrease during the COVID-19 pandemic and recovery in subsequent years. 18 (0.6%) patients had X-ray stage 0, 1,162 (38.3 %) – stage I, 1,527 (50.3%) – stage II, 302 (9.0%) – stage III, and 28 (0.9%) – stage IV. Löfgren’s syndrome was present in 387 (12.7%) patients, and extrapulmonary manifestations were found in 576 patients (19.0%). Identification rate in different regions of Tatarstan correlated with the size of the population. Overall, 44.7% patients had biopsy results, along with 47.3% before COVID-19 pandemic and 72.5% after the pandemic. After identification, a combination of pentoxifylline with vitamin E was prescribed in 32.9%, and vitamin E alone in 30.3%. Systemic corticosteroids were prescribed in 17.5%, and active monitoring without treatment was recommended in 15.8% cases. Postponing of immunosuppression was compliant with the clinical guidelines in Tatarstan. Conclusion. Analysis of data from the sarcoidosis register of the Republic of Tatarstan revealed an increase in detection before the COVID-19 pandemic, a decrease during the pandemic, and a resumption of growth together with an increase in biopsies afterwards. Management of patients after the diagnosis was characterized by the predominant active surveillance and immunosuppression strictly according to the therapeutic indications.