Clinical Evaluation of Sarcoidosis in Community Members with World Trade Center Dust Exposure
Clinical Evaluation of Sarcoidosis in Community Members with World Trade Center Dust Exposure
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DOI：
10.3390/ijerph16071291
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发表时间：
2019-04-01
影响因子：
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通讯作者：
Reibman, Joan
中科院分区：
文献类型：
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作者：
Hena, Kerry M.;Murphy, Scarlett;Reibman, Joan
背景：结节病是一种累及胸内和胸外器官的肉芽肿性疾病。遗传和环境因素，如9/11后接触世贸中心（WTC）粉尘，可能在临床表现中起作用。对接触WTC粉尘的社区成员结节病的特征分析可以进一步了解环境暴露与结节病之间的关系。方法：在WTC环境卫生中心（EHC）确诊结节病患者，该中心是社区成员的治疗项目。通过标准化问卷调查和图表回顾收集人口统计和临床数据。用标准仪器评估器官受累情况。结果：在WTC EHC患者中，有87例在911事件后被确诊为结节病。与非结节病的WTC EHC患者相比，结节病病例多为非洲裔美国人、当地工人，且有更多的呼吸道症状。许多（46%）患者的胸部影像学显示为Scadding 3期，肺功能指标降低。33/87例（38%）受累于胸外，受累于多种器官。结论：社区成员暴露于wtc的结节病通常以严重的肺部疾病和多种胸外受累率高为特征。需要进一步的分析来描述疾病进展或消退的过程。
Background: Sarcoidosis is a granulomatous disease involving intrathoracic and extrathoracic organs. Genetic and environmental factors, such as exposure to World-Trade Center (WTC) dust after 9/11, may play a role in clinical presentation. Characterization of sarcoidosis in community members with exposure to the WTC dust can provide further insight into the relationship between environmental exposure and sarcoidosis. Methods: Patients with documented sarcoidosis were identified in the WTC Environmental Health Center (EHC), a treatment program for community members. Demographic and clinical data were collected from standardized questionnaires and chart review. Organ involvement was assessed with a standard instrument. Results: Among patients in the WTC EHC, 87 were identified with sarcoidosis after 9/11. Sarcoidosis cases were more likely African-American, local workers, and had more respiratory symptoms, compared with non-sarcoidosis WTC EHC patients. Many (46%) had Scadding stage 3 on chest imaging, and had reduced lung function measures. Extrathoracic involvement was identified in 33/87 (38%) with a diversity of organs involved. Conclusions: WTC-exposed sarcoidosis in community members is often characterized by severe pulmonary disease and a high rate of diverse extrathoracic involvement. Further analysis is required to characterize the course of disease progression or resolution.