PO3 - Race-stratified phenotype of sarcoidosis in community pulmonary practice: a 10-year, multisite experience
Fortune Alabi (United States)1; Lusmelys Guevara (United States)1; Noah Andersen (United States)1; Jica Garces (United States)1; Kenny Alvarado (United States)1; Mohammad Ahmadzai (United States)1; Reema Ismail (United States)1;
1 - Florida Lung Asthma and Sleep specialists;
Keywords: Racial disparities; pulmonary function; Scadding staging stage;
Select the theme: Special Topics in Extrathoracic Sarcoidosis
Type: Original Papers
Presentation: Poster Presentation

Introduction: Sarcoidosis disproportionately affects Black/African American adults; Hispanic patients remain underrepresented in published series, which are typically drawn from tertiary referral centers. The race-stratified pulmonary and extrapulmonary phenotype of sarcoidosis in community pulmonary practice is less well characterized.

Objectives: To describe race-stratified pulmonary physiology, modified Scadding stage, and extrapulmonary organ involvement in a 10-year community pulmonary practice cohort with substantial Hispanic representation.

Materials and Methods: Retrospective five-site community pulmonary practice cohort, Central Florida, January 2016–January 2026. Adults with confirmed sarcoidosis and at least one of modified Scadding stage on chest CT, GLI 2012 spirometry pattern, or DLCO interpretation were stratified by self-reported race (White, Black/African American, Hispanic, Other/Unknown). Extrapulmonary involvement (cardiac by PET or MRI; bone by PET; hepatic by abnormal LFTs and PET; hypercalcemia as calcium ≥10.3 mg/dL) was abstracted from the electronic medical record. Continuous variables were compared with the Kruskal–Wallis test and categorical variables with the chi-square test or Fisher's exact test.

Results: 505 patients (213 White, 115 Black, 125 Hispanic, 52 Other/Unknown; mean age 62 ± 14 years; 63% female). Black patients demonstrated greater pulmonary impairment: lower DLCO % predicted (72 vs 82, p = 0.002), more abnormal DLCO (66% vs 45%, p = 0.002), and a 2.5-fold higher prevalence of stage IV fibrotic disease (20% vs 8%; overall p = 0.039). Extrapulmonary involvement also differed: neurosarcoidosis was more frequent in Black patients (13% vs 1–8%, p = 0.035), and pulmonary hypertension was twice as prevalent (21% vs 8–10%, p = 0.044). Hispanic patients showed a distinct phenotype with the highest prevalence of coexisting autoimmune/connective tissue disease (15%, p = 0.026) and ocular involvement (31%).

Conclusions: In a real-world community pulmonary cohort over a decade, black patients had a measurably more severe pulmonary and extrapulmonary phenotype, while Hispanic patients showed a distinct profile of greater autoimmune coexistence. Recognition of these race-specific phenotypes may inform surveillance and counseling in everyday specialty practice.