Sarcoidosis in Causians, Blacks and Asians in London

Abstract

The incidence and clinical features of sarcoidosis were studied in a retrospective survey of 156 patients attending two South London hospitals between 1969 and 1982. Sixty-eight patients were Caucasian, 59 were Black West Indian or African immigrants and 29 were immigrants racially derived from Indo-Pakistan (Asians). The annual incidence of sarcoidosis in the local community in 1977-78 was 19.8 per 10⁵ for Blacks and 16.8 per 10⁵ for Asians compared with 1.5 per 10⁵ for Caucasians. Erythema nodosum was a more common presenting feature in Caucasians than in Blacks (P<0.001) or Asians (P<0.05). Blacks developed sarcoidosis at a later age than Caucasians (P<0.05) and were less likely to present as a chance finding on a chest radiograph (P<0.05). They had more widespread extrathoracic disease than Caucasians (P<0.001) and were more commonly treated with corticosteroids (P<0.001). In the Asians there was a male predominance compared with Caucasians (P<0.01). Asians also had more extrathoracic sarcoidosis than Caucasians (P<0.001) and more of them were treated with corticosteroids (P<0.05). A stage 2 chest radiograph at presentation (P<0.05) and skin sarcoidosis (P<0.05) were less common in Asians than in Blacks, but otherwise there were no significant differences between the two groups. In this study the incidence of sarcoidosis in Asians approached that in Blacks, while the clinical features were intermediate in severity between Blacks and Caucasians. In both Blacks and Asians the disease was more common, more severe and more extensive than in Caucasians.