Sarcoidosis autopsies in Japan. Frequency and trend in the last 28 years

Records of sarcoidosis autopsies were collected from data books of all the autopsies in Japan, which have been published yearly by the Japanese Society of Pathology since 1958. The rate of sarcoidosis in comparison to total autopsies showed about a two-fold increase between the 1958-'63 period and 1979-'85, and a significant difference was noted between the rate in the previous 16 years and that in the following 12 years. Age distribution among both the sexes showed significant higher rates in the females of over 40 years of age than among the males of the same age group, due to the higher rates of cardiac sarcoidosis among the older females. The disease was thought to be increasing in all age groups. In over half of the sarcoidosis autopsies death from sarcoidosis was noted, among which cardiac sarcoidosis was the main cause of death. Clinical diagnosis for sarcoidosis had been obtained in only one third of the sarcoidosis as well as non-sarcoidosis deaths, indicating the difficulty in clinical diagnosis for cardiac sarcoidosis and the presence of many subclinical cases. The rate of sarcoidosis to total autopsy was three-fold or more of the prevalence rate of sarcoidosis in Japan.