Comparison of the young and elderly patients with newly revealed sarcoidosis
I.Yu. Vizel¹, E.I. Shmelev², A.A. Vizel¹, G.S. Ganibaeva<sup>3

1</sup> Kazan State Medical University
² Central Research Institute of Tuberculosis, Moscow
³ Republican Clinical Antituberculosis Dispensary, Kazan

Sarcoidosis is an epitheliocellular polyorganic granulomatosis of unknown nature, the prevalence of which has increased significantly over the past three decades. In all areas of medicine, older patients are a problem, primarily associated with polymorbidity.
Aim: compare patients with histologically confirmed sarcoidosis of a young (18–35 years) and older (55–75 years) age at the time of diagnosis (primary detection, before treatment).
Patients and Methods: the study consisted of a retrospective analysis of the database of patients observed by the authors of this publication in real clinical practice. The database was created in the SPSS-18 program. Statistical processing included the verification of the variation series for the normal distribution, the calculation of the mean, the error of the mean and standard deviation, the calculation of the conjugacy criterion CI-square (χ2), and the odds ratio.
1210 patients with sarcoidosis were examined during the primary detection between 1976 and 2017 (817 women and 393 men, 67.5% / 32.5%), the age ranged from 12 to 76 years, an average of 42.36 ± 0.35 (12.1) years. A comparison of 190 patients with histologically confirmed sarcoidosis of a young age (18–35 years old) and 110 patients of the older age group (55–75 years) was made during the diagnosis (primary detection, before treatment).
Results: no differences were found in the radial stages of sarcoidosis, there was a slight tendency towards a greater number of cases of Löfgren’s syndrome in older patients. Complaints were more pronounced and were more frequent in patients of the senior group — 60% weakness vs. 45.1% in young patients (p<0.01), cough — 47.2% vs. 31.1% (p<0.01), dyspnea — 40.9% vs. 24.4% (p<0.01), whereas the frequency of articular syndrome, fever, pain and discomfort in the chest did not differ. 60.6% of young patients were detected during fluorographic examination (vs. only 36.4%, p<0.001, in the elderly group). Diagnosis of sarcoidosis in young people was almost 2 times more often in TB dispensaries (40.9% vs 22.7%, p<0.001), in older patients — 
in oncology dispensaries (31.8% vs. 18.1%, p<0, 01). The treatment of patients did not differ, but in patients of the older age group the use of systemic glucocorticosteroids caused the adverse effects more often, and their effectiveness was lower.
Conclusion: the study showed that the age did not affect the frequency of occurrence of different radial stages of intrathoracic sarcoidosis and the nature of the therapy. The probability of revealing sarcoidosis when handling complaints is higher in older patients due to the greater frequency of complaints, disturbances in the function of external respiration and external manifestations (sarcoidosis of the skin), they have a worse tolerance to the hormone therapy. Sarcoidosis in young patients was more often detected during preventive examinations and their diagnostic pathway often passed through anti-tuberculosis institutions.

Key words: sarcoidosis, age, diagnosis, radiation stages, comorbidity, treatment, adverse effects.
For citation: Vizel I.Yu., Shmelev E.I., Vizel A.A., Ganibaeva G.S. Comparison of the young and elderly patients with newly revealed sarcoidosis // RMJ. 2018. № 10 (I). P. 16–20.