Sarcoidosis in the eastern region of Saudi Arabia

Aim: To review a general hospital's experience with sarcoidosis and the clinical pattern of the disease among Saudis.

Methods: A retrospective file review was carried out on all patients with a proven diagnosis of sarcoidosis in a general hospital in Eastern Saudi Arabia over a period of 11 years (1998-2008).

Results: Sixty-nine patients, of whom 33 cases were included in the analyses, were diagnosed to have sarcoidosis during the study period. There were 18 females and 15 males. The mean age was 44.5 years (SD 17). The most common presentations were cough (48%), dyspnea (21%), joint pain (18%), splenomegaly (12%), hepatomegaly (9%), and lymphadenopathy (5%). The biochemical analysis showed elevated calcium levels in 6% and elevated angiotensin converting enzyme (ACE) in 14 (46.7%). The tuberculin skin test was negative in all tested patients (n = 29) except one patient. The patients were classified using the modified Scadding classification system. None of the patients was in stage 0, 39.4% were in stage 1, 45% were in stage 2 and 15% were in stage 3.. The diagnosis in all patients was proven histologically. The outcome was favorable in most patients (85%), and in 6% of the patients, the course was chronic and progressive, although 66% received active treatment.

Conclusion: Sarcoidosis does occur in native Saudis. The clinical presentation of these patients was similar to the western pattern of disease with some differences such as relative lack of cardiac, eye, parotid, and central nervous system involvement. The rarity of cardiac and central nervous system involvement was comparable with other Middle Eastern studies. Sarcoidosis, though rare in our community, should still be considered in the differential diagnosis of patients with the typical presentation after excluding tuberculosis.