https://doi.org/10.4081/monaldi.2026.4313
60 years of sarcoidosis experience at an internal medicine clinic in Türkiye
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Accepted: 6 October 2026
Published: 23 October 2026
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.
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Romer FK, Hommelgaard P. Schou G. Sarcoidosis and cancer revisited: a long-term follow-up study of 555 Danish sarcoidosis patients. Eur Respir J 1998;12:906-12. DOI: https://doi.org/10.1183/09031936.98.12040906
BaughmanRP, Teirstein AS, Judson MA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001;164:1885-9. DOI: https://doi.org/10.1164/ajrccm.164.10.2104046
Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160:736-55.
Newman LS, Rose CS, Maier LA. Sarcoidosis. N Engl J Med 1997;336:1224-34. DOI: https://doi.org/10.1056/NEJM199704243361706
Merten DF, Kirks DR, Grossman H. Pulmonary sarcoidosis in childhood. AJR 1980,135:673-9. DOI: https://doi.org/10.2214/ajr.135.4.673
De Remee RA. The roentgenographic staging of sarcoidosis. Historic and contemporary perspectives. Chest 1983;1:128-33. DOI: https://doi.org/10.1378/chest.83.1.128
Pietinalho A, Hiraga Y, Hosoda Y, et al. The frequency of sarcoidosis in Finland and Hokkaido, Japan. A comparative epidemiological study. Sarcoidosis 1995;12:61-7
Kolek V. Epidemiological study on sarcoidosis in Moravia and Silesia. Sarcoidosis 1994;11:110-2.
Mayock RL, Bertnard P, Morrison CE. Manifestations of sarcoidosis: analysis of 145 patients with a review of nine series selected from the literature. Am J Med 1963;35:67-89. DOI: https://doi.org/10.1016/0002-9343(63)90165-7
Loddenkemper R, Kloppenborg A, Schoenfeld N, et al. Clinical findings in 715 patients with newly detected pulmonary sarcoidosis results of a cooperative study in former West Germany and Switzerland. Sarcoidosis Vasc Diffuse Lung Dis 1998:15:178-82.
James DG, Neville E, Siltzbach LE. A worldwide review of sarcoidosis. Ann NY Acad Sci 1976;278:321-34. DOI: https://doi.org/10.1111/j.1749-6632.1976.tb47043.x
Stjemberg N, Thunell M, Lundgren R. Comparison of flexible fiberoptic bronchoscopy and scalene lymph node biopsy in the diagnosis of sarcoidosis. Endoscopy 1983;15:300-1. DOI: https://doi.org/10.1055/s-2007-1021539
Yanardag H, Caner M, Kaynak K, et al. Clinical value of mediastinoscopy in the diagnosis of sarcoidosis: an analysis of 68 cases. Thorac Cardiovasc Surg 2006;54:198-201. DOI: https://doi.org/10.1055/s-2005-872996
Hannuksela M, Salo OP, Mustakallio KK. The prognosis of acute untreated sarcoidosis. Ann Clin Res 1970;2:57-61.
Milman N, Selroos O. Pulmonary sarcoidosis in the Nordic countries 1950-82. Epidemiology and clinical picture. Sarcoidosis 1990;7:50-7.
Yanardag H, Pamuk ON, Karayel T. Löfgren syndrome in Turkey. Intern Med J 2003;33:535-7. DOI: https://doi.org/10.1046/j.1445-5994.2003.00466.x
Mana J, Gomez-Vaquero C, Montero A, Salazar A, et al. Löfgren's syndrome revisited: a study of 186 patients. Am J Med 1999;107:240-5. DOI: https://doi.org/10.1016/S0002-9343(99)00223-5
Mana J, Marcoval J, Graells J, et al. Cutaneous involvement in sarcoidosis: relationship to systemic disease. Arch Dermatol 1997;133:882-8. DOI: https://doi.org/10.1001/archderm.1997.03890430098013
Yanardag H, Pamuk ON, Karayel T. Cutaneous involvement in sarcoidosis: analysis of the features in 170 patients. Respir Med 2003;97:978-82. DOI: https://doi.org/10.1016/S0954-6111(03)00127-6
Jabs DA, Johns CJ. Ocular involvement in chronic sarcoidosis. Am J Ophthalmol 1986;102:297-301. DOI: https://doi.org/10.1016/0002-9394(86)90001-2
Karma A, Huhti E, Poukkula A. Course and outcome of ocular sarcoidosis. Am J Ophthalmol 1988,106:467-72. DOI: https://doi.org/10.1016/0002-9394(88)90885-9
Yanardag H, Tetikkurt C, Bilir M, Pazarlı H. Clinical features and the prognostic significance of ocular sarcoidosis. Arch Pulmonol Respir Care 2018;4:006-011. DOI: https://doi.org/10.17352/aprc.000032
Ellman L. Bone marrow biopsy in the evaluation of lymphoma, carcinoma and granulomatous disorders. Am J Med 1976;60:1-7. DOI: https://doi.org/10.1016/0002-9343(76)90527-1
Scadding JG, Mitchell DN. Sarcoidosis. 2nd ed. London, UK: Chapman and Hall Medical. 1985. DOI: https://doi.org/10.1007/978-1-4899-2971-6
Thomas PD, Hunninghake GW. Current concepts of the pathogenesis of sarcoidosis. Am Rev Respir Dis 1987;135:747-60.
Bilir M, Sipahi S, Yilmaz E, et al. Analysis of HLA antigens in Turkish sarcoidosis patients. Southern Med J 2007;100:356-60. DOI: https://doi.org/10.1097/SMJ.0b013e31802f3763
Akokan G, Çelikoğlu S. Göksel FM, Demirci S. Antigens in Turkish patients with sarcoidosis. N Engl J Med 1977;296:759 DOI: https://doi.org/10.1056/NEJM197703312961320
Cotter TP, Brodin CP. The relationship between the tuberculin test and the Kveim test in sarcoidosis in Ireland. Ir J Med Sci 1995; 164:24-5. DOI: https://doi.org/10.1007/BF02968108
Wigley RD. Moratorium on Kveim tests. Lancet 1993,341:1284. DOI: https://doi.org/10.1016/0140-6736(93)91190-W
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