Bidirectional association between tuberculosis and sarcoidosis
Sheng-Huei Wang
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorChi-Hsiang Chung
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
Search for more papers by this authorTsai-Wang Huang
Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorWen-Chiuan Tsai
Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorChung-Kan Peng
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorKun-Lun Huang
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorWann-Cherng Perng
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorChih-Feng Chian
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorWu-Chien Chien
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
School of Public Health, National Defense Medical Center, Taipei, Taiwan
C.-H.S. and W.-C.C. contributed equally to this work.Search for more papers by this authorCorresponding Author
Chih-Hao Shen
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
C.-H.S. and W.-C.C. contributed equally to this work.Correspondence: Chih-Hao Shen, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Gong Road, Neihu 114, 11490 Taipei, Taiwan. Email: [email protected]Search for more papers by this authorSheng-Huei Wang
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorChi-Hsiang Chung
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
Search for more papers by this authorTsai-Wang Huang
Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorWen-Chiuan Tsai
Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorChung-Kan Peng
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorKun-Lun Huang
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorWann-Cherng Perng
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorChih-Feng Chian
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Search for more papers by this authorWu-Chien Chien
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
School of Public Health, National Defense Medical Center, Taipei, Taiwan
C.-H.S. and W.-C.C. contributed equally to this work.Search for more papers by this authorCorresponding Author
Chih-Hao Shen
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
C.-H.S. and W.-C.C. contributed equally to this work.Correspondence: Chih-Hao Shen, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Gong Road, Neihu 114, 11490 Taipei, Taiwan. Email: [email protected]Search for more papers by this authorABSTRACT
Background and objective
Tuberculosis (TB) and sarcoidosis are both granulomatous diseases with potential interassociations. However, much uncertainty remains; thus, the present study aimed to clarify the association between these diseases.
Methods
We established two cohorts in this retrospective longitudinal cohort study using data obtained from the Taiwan National Health Insurance Database from 2000 to 2015. One cohort, which comprised 31 221 patients with TB and 62 442 age-, sex- and index year-matched controls, was used to analyse the risk of sarcoidosis; the other cohort comprised 2442 patients with sarcoidosis and 9688 controls and was used to assess the risk of TB. A Cox proportional hazards model adjusted for potential confounders was used in each cohort.
Results
Patients with TB showed an 8.09-fold higher risk of developing sarcoidosis than non-TB subjects (95% CI = 3.66–17.90), whereas patients with sarcoidosis showed a 1.85-fold higher risk of developing TB than non-sarcoidosis subjects (95% CI = 1.36–2.50). The TB subtype analysis revealed the highest risk of developing sarcoidosis in patients with extrapulmonary TB, and the highest risk of developing extrapulmonary TB was observed in patients with sarcoidosis compared with non-sarcoidosis subjects. Patients with TB showed a higher risk of developing sarcoidosis throughout the follow-up period, but patients with sarcoidosis only showed a higher risk of developing TB within the first year.
Conclusion
TB is a risk factor for developing sarcoidosis. The results of this bidirectional cohort study also highlight the clinical difficulty of diagnosing sarcoidosis and TB.
Supporting Information
| Filename | Description |
|---|---|
| resp13482-sup-0001-AppendixS1.docWord document, 127 KB |
Table S1 (A) Years to sarcoidosis in arm 1. (B) Years to tuberculosis in arm 2. Table S2 (A) Subgroup analysis and comparison of the incidence rates and adjusted HR in arm 1. (B) Subgroup analysis and comparison of the incidence rates and adjusted HR in arm 2. Table S3 Immunosuppressive treatment of sarcoidosis patients in arm 2 (n = 2422). |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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