Long term prognosis of sarcoidosis in Arabs and Asians: Predictors of good outcome

Background: The prognosis of sarcoidosis is variable and often difficult to predict. Our aim was to identify predictors of good prognosis in Arabs and Asians with sarcoidosis. Methods: Data on patients with sarcoidosis followed up for at least 3 years in two major hospitals in Kuwait were collected retrospectively for the period 1983 to 1995 and prospectively from 1995. Results: Of the total 115 patients, 60% were females and 80% were Arabs. Majority, 86.9%, of the patients had either Stage I or II disease. Forty-five (43.7%) were followed up for 3 to 5 years, 43 (41.7%) for 5 to 9 and 15 (14.6%) for 10 or more years while 12 were lost to follow up. Good prognosis was seen in 53 (51%), intermediate in 33(32%) and poor in 17 (17%) patients. Two patients (1.9%) died. Good prognosis was observed in 74.4% of patients with Stage I ,40% of patients with Stage II and 16.7% with stage III disease, p = 0.001. In addition, presence of arthralgia predicted a good prognosis, p = 0.014. Hypercalcemia was noted only in patients with poor or intermediate outcome. Gender, ethnicity, and presence of erythema nodosum were not predictors of prognosis in our patients. Multivariate logistic regression analysis confirmed that early stage of the disease [OR (95%CI), 6.1 (2.3-15.7), p = 0.001] and presence of arthralgia, [OR (95%CI), 4.5 (1.3-15.4), p = 0.02] were predictors of good prognosis. Conclusion: Presence of arthralgia and early stage of the disease were the most important predictors of good prognosis. Sex, age, ethnicity and presence of erythema nodosum did not influence the prognosis.