Sarcoidosis in the United States Military Health System.

Rationale: Sarcoidosis is an inflammatory disorder of unclear etiology with historical significance in the U.S. Department of Defense (DoD).

Objectives

This study sought to characterize the sarcoidosis population within the DoD Military Health System (MHS).

Methods

Adult patients with sarcoidosis were identified in the DoD MHS database from 01-JAN-2004 through 31-DEC-2013. Patients required ≥3 encounters with a sarcoidosis diagnosis and continuous MHS eligibility. Index was defined as date of first sarcoidosis encounter. Comorbidities were assessed within the pre-index and follow-up periods. Additionally, a subset of sarcoidosis patients was identified as having conditions that can be associated with cardiac sarcoidosis. Measurements and Main

Results

The final sarcoidosis cohort was 9,908 patients, 57% female, and had a mean (SD) age of 53.1 (13.6) years. The region with the largest population was the east coast (45.6%). The top 5 pre-index comorbidities were hypertension (51.7%), fatigue (27.0%), anemia (21.4%), diabetes, type II (19.6%), and coronary heart disease (16.5%). Prevalence of the following conditions increased ≥2-fold from pre-index to follow-up: leukocytopenia, pulmonary hypertension, chronic kidney disease, thrombocytopenia, hypercalcemia, venous thromboembolism, congestive heart failure, seizure disorder, stroke/TIA, hypercalciuria, and arthritis. Of the sarcoidosis cohort, 21.8% (n=2,164) were identified as having cardiac conditions that can be associated with cardiac sarcoidosis. The top conditions in this cohort were cardiac arrhythmia (75.6%), congestive heart failure (20.4%), and cardiomyopathy (13.6%).

Conclusions

The MHS has a large population of sarcoidosis patients, of which 22% had cardiac conditions that can be associated with granulomatous inflammation of the heart. Prevalence of numerous comorbid conditions increased after sarcoidosis diagnosis. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 261-267).