RACIAL DIFFERENCE IN CARDIAC SARCOIDOSIS INCIDENCE OBSERVED AT AUTOPSY

The most commonly involved organ in sarcoid related death has been rep orted to be the lung in western countries, while it was the heart in t he Japanese autopsy series. In order to verify this different pattern of death, autopsy records were reviewed in two United States instituti ons and in Japanese nation-wide data. In Japanese, male to female rati o was 1:2 and a high frequency of sarcoidosis in females over 50 years of age was observed. Male to female ratio in Caucasian sarcoidosis au topsy was nearly 1:1. In Afroamericans, it was nearly 1:2, and the age distribution showed that this female predominance was due to a high n umber of sarcoidosis in females over 40 years of age. The frequency of sarcoidosis in Caucasian autopsies was higher than in Japanese autops ies. The number of involved organs was smaller in Caucasians than in A froamericans or in Japanese. The incidence of cardiac sarcoid granulom a in Japanese was significantly higher than that seen in Caucasians an d Afroamericans. The commonest cause of death in sarcoidosis of Caucas ians and Afroamericans was from non-sarcoid diseases, while the major cause of sarcoid-attributed death was pulmonary sarcoidosis in Afroame ricans. Japanese showed the highest rate of cardiac sarcoid-attributed death. Possible factors relating to this high incidence of sarcoidosi s in elderly females and the racial difference in cardiac sarcoidosis were discussed.