Sarcoidosis and tuberculosis in South Croatia: are there epidemiological similarities or not?

OBJECTIVE: Tuberculosis and sarcoidosis are chronic granulomatous diseases. Clinical, pathologic and immunologic aspects are similar although different. The authors were interested to highlight possible epidemiological similarities of these two granulomatous diseases. The objective of this study was to evaluate incidence rate as well as age, sex and geographic distribution of sarcoidosis in South Croatia and to compare it with these epidemiological characteristics of tuberculosis. STUDY DESIGN: Retrospective. METHODS: The study was including ten years follow up period (1997-2006), and was performed in Split-Dalmatia County, Croatia. All data were collected retrospectively and analyzed using Statistica 7 programme. RESULTS: The mean annual incidence of sarcoidosis was 3.3/100,000 inhabitants with a mean of 15,6 cases per year. Woman accounted for 61% of all sarcoidosis cases. The mean sarcoidosis patient age was 44.94 ± 11.85 years. The peak age group was 40-49 years (31%). Significant difference according to incidence rate on the islands comparing to the rates on the coast and the mainland was observed (P = 0.003). The mean sarcoidosis mortality rate was 1.2/100,000. Statistically significant differences between sarcoidosis and tuberculosis were observed according the higher number of tuberculosis patients (P < 0.000), among males (P < 0.000), and females, too (P < 0.000) as well as in mortality rates (P = 0.401). Significantly more patients had tuberculosis on the mainland (P < 0.000) and on the coast (P < 0.000), but not in the islands (P = 0.260). CONCLUSIONS: The results from this study showed dissimilarities in classic epidemiological patterns between sarcoidosis and tuberculosis, incidence rates, as well as sex and geographic distribution. Our findings resulted from this study might be starting point for the future epidemiological, genetic, and immunological studies.

Hepatitis B in the family.

During a 3-year period (1992-1995), 239 index cases of hepatitis B virus (HBV) infection and 459 members of their households from the Osijek-Baranja county were examined. The aim of the study was to determine the spread of HBV infection in the families with a member verified as a virus carrier, and to identify the family members with the highest risk of infection according to kinship degrees. The retrospective and prospective methods were used in the study. The probable route of infection was assessed by the use of an epidemiologic questionnaire, and the serologic status of the study subjects concerning infection with HBV was determined by enzyme immunoassays (HBsAg, anti-HBs, anti-HBe and anti-HBc). The first member of a family identified as a virus carrier was considered an index case. HBV infection was demonstrated in 334 (47.85%) out of a total of 698 subjects. Only 21 (6.28%) of the 334 subjects with verified HBV infection developed the clinical picture of acute hepatitis B. The ratio of clinically manifest vs inapparent infection was 1:16. Serologic traces of infection were detected in 95 of the 459 family members of the index cases, yielding a mean rate of the infection among the virus carrier family members of 20.70%.

[Changes in thyroid function in systemic lupus erythematosus, progressive systemic sclerosis and rheumatoid arthritis]. / Poremecaji funkcije stitnjace kod sistemskog eritematoznog lupusa, progresivne sistemne skleroze i reumatoidnog artritisa.

According to frequent thyroid function disorders in systemic connective tissue diseases a group of 380 patients were analysed - 70 with systemic erythematous lupus (SLE), 31 with progressive systemic scleris (PSS) and 270 with rheumatoid arthritis (RA). Thyroxine (T4) and triodothyronine (T3) were measured by radioimmunoassay technique and thyroid stimulating hormone (TSH) chronologically by monoclonal antibody technique and thereafter by fluoroimmunoassay. Thyreopahty was found at 15 patients with SLE (21.43%), 11 patients with PSS (35.48%) and 35 patients with RA (12.54%). Our results pointed out the significant frequency of thyroid function disorders in these diseases and imply the necessity of the routine thyroid function follow up, therefore to take adequate cure in due time.