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Sarklíki á Íslandi 1981-2003

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Authors
Sigríður Ólína Haraldsdóttir
Kristín Bára Jörundsdóttir
Friðrik Yngvason
Jóhannes Björnsson
Þórarinn Gíslason
Issue Date
2007-02-01

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Sarcoidosis in Iceland 1981-2003
Citation
Læknablaðið 2007, 93(2):105-9
Abstract
OBJECTIVE: To investigate the incidence of sarcoidosis in Iceland, its clinical manifestations and potential environmental influences. MATERIALS AND METHODS: All histopathological diagnoses of non-necrotizing granulomas generated in Iceland during the period 1981-2003 were reviewed with respect to a diagnosis of sarcoidosis. Further, patients were identified by searching hospital discharge diagnoses at the University Hospital in Reykjavik and the Regional Hospital in Northern Iceland. Only histologically verified cases were included. RESULTS: A total of 235 patients were found with histopathologically proven sarcoidosis. Limited to patients verified by tissue diagnosis, the annual incidence of sarcoidosis is 3,84/100.000/year. The incidence was found to be 2,8/100,000/year during the first half of the investigation period and 5,0/100,000/year during the second. This rate is lower than in other Nordic countries. There were 122 women and 113 men. The mean age at diagnosis was 50,8 years for women and 47,5 for men. The mean age at diagnosis was higher in Iceland than elsewhere. Clinically, respiratory symptoms predominated. Ocular symptoms and erythema nodosum are rare, and life-threatening cardiovascular and neurological manifestations are distinctly unusual. CONCLUSION: The low incidence is undoubtedly due to the strict inclusion criteria in the present study, i.e. only those with a tissue diagnosis were included. We have no explanation as to the higher age at diagnosis in Iceland than elsewhere. Registration of possible environmental factors and clinical evaluation may be improved.
Tilgangur: Markmið rannsóknarinnar var að kanna tíðni sarklíkis á Íslandi, birtingarform sjúkdómsins og mögulega áhrifaþætti umhverfis. Efniviður og aðferðir: Allar vefjagreiningar á árunum 1981-2003 á hnúðabólgu á rannsóknastofum í meinafræði voru kannaðar og sarklíkitilfelli vinsuð frá. Útskriftargreiningar á Landspítala og Fjórðungssjúkrahúsinu á Akureyri voru kannaðar með tilliti til sarklíkis og athugað hvort vefjagrein-ing lægi fyrir. Þeir sem greindust með sarklíki samkvæmt vefjasýni mynda rannsóknarhópinn. Niðurstöður: Alls fundust 235 sjúklingar með sarklíki og var nýgengið 3,84/100 þús/ári. Á fyrri hluta rannsóknartímabilsins var nýgengið 2,8/100 þús/ári, en hlutfallslega hærra, 5/100 þús/ári, á seinni helmingi tímabilsins. Nýgengi sarklíkis var lægra en annars staðar á Norðurlöndunum. Konur voru 122 (52%) og karlar 113 (48%). Meðalaldur kvenna við greiningu var 50,8 ár, en meðalaldur karla 47,5 ár. Meðalaldur var hærri við greiningu hér á landi en víðast annars staðar. Algengust voru einkenni frá öndunarfærum. Augneinkenni og hnútarós var sjaldgæft í þessum hópi og lífshættuleg einkenni frá hjarta eða taugakerfi voru afar sjaldgæf meðal íslenskra sarklíkissjúklinga. Ályktun: Lægra nýgengi má líklega rekja til strangari inntökuskilyrða í þessari rannsókn en í öðrum faraldsfræðilegum rannsóknum. Skýring á hærri meðalaldri við greiningu liggur ekki ljós fyrir. Skráning mögulegra áhrifaþátta sarklíkis og uppvinnsla sjúklinga þyrfti að vera markvissari.
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