PO120 - Infection Burden in Sarcoidosis: Insights from a Single-Center Cohort
Claudia Tejera Quesada (United States)1; Joseph Barney (United States)1; Drew Robinson (United States)1;
1 - University of Alabama at Birmingham;
Keywords: Immunophenotype; Infection; Sarcoidosis;
Select the theme: Genetics and Immunopathology: Advances in Contemporary Understanding and Prospects for Future Research
Type: Original Papers
Presentation: Poster Presentation

Introduction: Sarcoidosis patients receiving immunosuppressive therapy are at an increased risk for infectious complications from both disease-related immune dysregulation and treatment-related immunosuppression. Specific factors associated with increased risk of infection have not been well described.

Objectives: To identify clinical and laboratory risk factors for infection among sarcoidosis patients receiving immunosuppressive therapy. By evaluating a broad range of clinical and laboratory characteristics, this study aims to improve infection risk stratification in treated sarcoidosis.

Materials and Methods: We performed a retrospective descriptive analysis of 40 patients. Demographic features, immunosuppressive regimens, organ involvement, and baseline hematologic and immunologic parameters were extracted to determine their relationship with the presence of infections. Descriptive statistics were used to compare patient subgroups with and without infections.

Results: The cohort consisted of 24 females (60%), 23 Black patients (57.5%), and a mean age of 55 (SD 9). 25 patients had multiorgan involvement and 30 had pulmonary sarcoidosis with or without extrapulmonary manifestations.

16 patients (40%) developed at least one infection. Infections occurred in 53.3% of the 30 patients with pulmonary disease, whereas none of the 10 patients without pulmonary involvement developed any type of infection. Infection rates were proportionally higher in Black patients (47.8% vs 29.4) and in males (43.8% vs 37.5). High infection rates were observed in patients receiving high-dose prednisone (75%), high-dose methotrexate (50%), and prednisone plus another immunosuppressant (46.2%).

42.5% (n=17) exhibited low absolute lymphocyte counts, 22.5% (n=9) had low IgG, and 15% (n=6) had low IgM. 56% of patients with low IgG developed infections, but a relatively lower proportion of those with absolute lymphopenia developed infections (29%).

Conclusions: In this retrospective cohort, infectious complications were common in those with pulmonary disease, Black patients, males, low IgG levels, and in those with intensive immunosuppressive regimens. Recognition of infection risk patterns in complex sarcoidosis care remains crucial for risk stratification. 

Table 1- Patient Characteristics3190_1.pdf