Lung sarcoid associated with inhaled dusts, liver and speen sarcoid with infections?

An interesting study of the relationship between exposures and the site of sarcoid involvement. Lung only sarcoidosis associated with silica and metal exposures (inorganic dusts) and organic dusts suggesting an inhalational route for the the association. Liver and spleen involvement was associated with livestock and humans (healthcare, teaching) perhaps suggesting a microbial association (or ingested?). Cardiac sarcoidosis was associated with reactive chemical exposures (isocyanates, acrylates, epoxy resins). The numbers here were small but reactive chemicals bind with body proteins to produce neo-antigens. Smokers were more likely to have eye involvement (a mystery). This study could only have been done in a centre screening all patients with sarcoidosis for extrathoracic involvement, and taking an occupational history, something we should all be doing.

References

	Ronsmans S, Ridder JD, Vandebroek E, Keirsbilck S, Nemery B, Hoet PHM, Vanderschueren S, Wuyts WA, Yserbyt J, Associations between occupational and environmental exposures and organ involvement in sarcoidosis: a retrospective case-case analysis, Respiratory Research, 2021;22:224,https://doi.org/10.1186/s12931-021-01818-5

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