Sarcoidosis among Chinese in Taiwan

Sarcoidosis is a multisystem disorder of unknown causes, characterized by widespread noncaseating epithelioid cell granuloma in more than one organ. It is rare among Chinese people. In recent years, a rapidly increasing incidence among inpatients of the Veterans General Hospital-Taipei has been noted. We retrospectively reviewed the records at our hospital from January 1960 through December 1995. We found 38 cases of sarcoidosis with biopsy-proven involvement of at least one organ system, in addition to either a typical clinical manifestation or chest radiograph. The disease-specific rate per thousand admissions increased from 0.0025 in the 1960s to 0.004 in the 1980s: for 1990 to 1995, it jumped to 0.027. Two possible explanations for the increasing incidence are greater awareness and recognition of this disease among physicians and pathologists, and advances in invasive diagnostic techniques and histopathology. Compared with patients in Western countries, sarcoidosis among Chinese patients in Taiwan had the following characteristics: 1) a higher frequency of patients (97%) had intrathoracic involvement, 2) there was a low incidence of hypercalcemia and hyperglobulinemia, and 3) there was an inclination toward older age at presentation. In conclusion, the incidence of sarcoidosis among Chinese in Taiwan has increased in the past 3 decades. The clinical presentations of patients differed from those reported from Western countries.