60 years of sarcoidosis experience at an internal medicine clinic in Türkiye

Sarcoidosis is a multisystemic granulomatous disease with a variable clinical presentation and prognosis. This study aimed to evaluate the demographic characteristics, clinical features, diagnostic methods, and extrapulmonary manifestations of sarcoidosis in patients followed at a single center over a 60-year period to better understand the features of sarcoidosis and its regional characteristics in Türkiye, since it is a disease with varying presentations in different regions of the world. Archive findings of 720 patients diagnosed with sarcoidosis at Cerrahpasa Medical Faculty between 1964 and 2023 were retrospectively analyzed. Demographic data, chest radiographic stage, extrapulmonary involvement, diagnostic methods, and results of tuberculin skin and Kveim test results were included in the study. Results of human leukocyte antigen (HLA) analysis and bone marrow biopsy findings of the patients on whom these tests were performed were also included. Statistical analyses were performed using chi-square and Mann–Whitney U tests. Women accounted for 67.3% of patients, and 79.2% of all patients were between 20 and 50 years of age. Stage I (52.9%) and stage II (28.3%) disease predominated at diagnosis. Transbronchial biopsy was the most common diagnostic method (43.6%). Löfgren’s syndrome was observed in 17% of patients. Skin (32.9%) and ocular (13.6%) involvement were the most frequent extrapulmonary manifestations. Bone marrow granulomas were detected in 10% of biopsied patients. Several HLA antigens showed significant associations with sarcoidosis. PPD positivity was 30.9%, whereas the Kveim test was positive in 76.7% of tested patients. According to our findings, sarcoidosis in Türkiye predominantly affects women aged 20–50 years and is usually diagnosed at stage I. Skin and eye involvement were the most common extrapulmonary manifestations, emphasizing the importance of systemic evaluation. The findings also support a genetic contribution to disease and demonstrate the value of histopathological confirmation, especially by transbronchial biopsy, in establishing the diagnosis.