Iwai K, Sekiguti M, Hosoda Y, DeRemee R A, Tazelaar H D, Sharma O P, Maheshwari A, Noguchi T I
Research Institute of Tuberculosis, Japan Antituberculosis Association, Tokyo.
Sarcoidosis. 1994 Mar;11(1):26-31.
The most commonly involved organ in sarcoid related death has been reported to be the lung in western countries, while it was the heart in the Japanese autopsy series. In order to verify this different pattern of death, autopsy records were reviewed in two United States institutions and in Japanese nation-wide data. In Japanese, male to female ratio was 1:2 and a high frequency of sarcoidosis in females over 50 years of age was observed. Male to female ratio in Caucasian sarcoidosis autopsy was nearly 1:1. In Afroamericans, it was nearly 1:2, and the age distribution showed that this female predominance was due to a high number of sarcoidosis in females over 40 years of age. The frequency of sarcoidosis in Caucasian autopsies was higher than in Japanese autopsies. The number of involved organs was smaller in Caucasians than in Afroamericans or in Japanese. The incidence of cardiac sarcoid granuloma in Japanese was significantly higher than that seen in Caucasians and Afroamericans. The commonest cause of death in sarcoidosis of Caucasians and Afroamericans was from non-sarcoid diseases, while the major cause of sarcoid-attributed death was pulmonary sarcoidosis in Afroamericans. Japanese showed the highest rate of cardiac sarcoid-attributed death. Possible factors relating to this high incidence of sarcoidosis in elderly females and the racial difference in cardiac sarcoidosis were discussed.
据报道，在西方国家，结节病相关死亡中最常累及的器官是肺，而在日本的尸检系列中则是心脏。为了验证这种不同的死亡模式，对美国两家机构的尸检记录以及日本全国的数据进行了回顾。在日本，男女比例为1:2，观察到50岁以上女性结节病的发病率较高。白种人结节病尸检中的男女比例接近1:1。在非裔美国人中，该比例接近1:2，年龄分布表明这种女性占优势是由于40岁以上女性结节病的数量较多。白种人尸检中结节病的发生率高于日本尸检。白种人受累器官的数量比非裔美国人或日本人少。日本心脏结节病肉芽肿的发生率明显高于白种人和非裔美国人。白种人和非裔美国人结节病最常见的死亡原因是非结节病相关疾病，而非裔美国人结节病归因死亡的主要原因是肺部结节病。日本人心脏结节病归因死亡的发生率最高。讨论了与老年女性结节病高发以及心脏结节病种族差异相关的可能因素。
