ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Dust Matters: Comparison of Sarcoidosis in World Trade Center-Exposed First Responders to an Unexposed Cohort
Session Title
TP62 - TP062 TERRORISM AND INHALATIONAL DISASTERS: WORLD TRADE CENTER AND BEYOND
Abstract
A3066 - Dust Matters: Comparison of Sarcoidosis in World Trade Center-Exposed First Responders to an Unexposed Cohort
Author Block: R. Gupta1, G. Millio2, I. Oriaku1, H. Zhao3, J. Skarre4, A. G. Desai4; 1Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, United States, 2Internal Medicine, Temple University, Philadelphia, PA, United States, 3Clinical Sciences, Temple University, Philadelphia, PA, United States, 4Medicine, Stony Brook University, Stony Brook, NY, United States.
Introduction: Sarcoidosis is an inflammatory disease that predominantly affects lungs. Genetic predisposition and environmental exposure play key roles in the pathophysiology of sarcoidosis. Prior studies have identified that debris from the fallen World Trade Center (WTC) towers is a risk factor for subsequent sarcoidosis development. A unique cohort of patients with sarcoidosis include first responders during the 9/11 WTC attack. We compared the disease phenotype of these first responders managed at the Stony Brook University Hospital (SBUH) to that of unexposed patients managed at Temple University Hospital (TUH). Methods: Patients from both centers who met the ATS diagnostic criteria for sarcoidosis were included in the study. The SBUH cohort included 16 first responders under the care of the WTC Health Program and referred to the Center for ILD at SBUH for sarcoidosis. The TUH cohort included 32 propensity-matched (for age, sex, race, and BMI) patients with sarcoidosis managed at TUH. The two cohorts were compared using Chi-squared tests for categorical variables and 2-sample t-tests for continuous variables. Results: Patients in the WTC cohort had significantly more rhinosinusitis and less wheezing. Initial lung function, and extrapulmonary manifestations were worse in the TUH cohort. There was a greater use of anti-inflammatory treatment, as well as more wheezing and lower lung function on follow-up testing in the TUH cohort. No CT findings were significantly different (Table 1). Conclusions: Our analysis reveals that patients in the WTC cohort had more upper airway symptoms with better lung function compared to the TUH cohort, who had lower respiratory tract disease and reduced lung function. This was also reflected in increased need for anti-inflammatory treatment in the TUH population. Our study is limited by its retrospective nature as well as the contribution of comorbid conditions such rhinosinusitis and laryngopharyngeal reflux, which are well documented in WTC victims. Additionally, the WTC cohort were likely healthier individuals at baseline. This study demonstrates the key differences in patients with sarcoidosis based on exposure type, which may affect disease trajectory and treatment options.
Author Block: R. Gupta1, G. Millio2, I. Oriaku1, H. Zhao3, J. Skarre4, A. G. Desai4; 1Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, United States, 2Internal Medicine, Temple University, Philadelphia, PA, United States, 3Clinical Sciences, Temple University, Philadelphia, PA, United States, 4Medicine, Stony Brook University, Stony Brook, NY, United States.
Introduction: Sarcoidosis is an inflammatory disease that predominantly affects lungs. Genetic predisposition and environmental exposure play key roles in the pathophysiology of sarcoidosis. Prior studies have identified that debris from the fallen World Trade Center (WTC) towers is a risk factor for subsequent sarcoidosis development. A unique cohort of patients with sarcoidosis include first responders during the 9/11 WTC attack. We compared the disease phenotype of these first responders managed at the Stony Brook University Hospital (SBUH) to that of unexposed patients managed at Temple University Hospital (TUH). Methods: Patients from both centers who met the ATS diagnostic criteria for sarcoidosis were included in the study. The SBUH cohort included 16 first responders under the care of the WTC Health Program and referred to the Center for ILD at SBUH for sarcoidosis. The TUH cohort included 32 propensity-matched (for age, sex, race, and BMI) patients with sarcoidosis managed at TUH. The two cohorts were compared using Chi-squared tests for categorical variables and 2-sample t-tests for continuous variables. Results: Patients in the WTC cohort had significantly more rhinosinusitis and less wheezing. Initial lung function, and extrapulmonary manifestations were worse in the TUH cohort. There was a greater use of anti-inflammatory treatment, as well as more wheezing and lower lung function on follow-up testing in the TUH cohort. No CT findings were significantly different (Table 1). Conclusions: Our analysis reveals that patients in the WTC cohort had more upper airway symptoms with better lung function compared to the TUH cohort, who had lower respiratory tract disease and reduced lung function. This was also reflected in increased need for anti-inflammatory treatment in the TUH population. Our study is limited by its retrospective nature as well as the contribution of comorbid conditions such rhinosinusitis and laryngopharyngeal reflux, which are well documented in WTC victims. Additionally, the WTC cohort were likely healthier individuals at baseline. This study demonstrates the key differences in patients with sarcoidosis based on exposure type, which may affect disease trajectory and treatment options.
