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Am. J. Respir. Crit. Care Med., Volume 164, Number 11, December 2001, 2085-2091

Familial Aggregation of Sarcoidosis
A Case-Control Etiologic Study of Sarcoidosis (ACCESS)

BENJAMIN A. RYBICKI, MICHAEL C. IANNUZZI, MARGARET M. FREDERICK, BRUCE W. THOMPSON, MILTON D. ROSSMAN, EDDY A. BRESNITZ, MICHAEL L. TERRIN, DAVID R. MOLLER, JULIANA BARNARD, ROBERT P. BAUGHMAN, LOUIS DePALO, GARY HUNNINGHAKE, CAROL JOHNS,dagger MARC A. JUDSON, GENELL L. KNATTERUD, GEOFFREY McLENNAN, LEE S. NEWMAN, DAVID L. RABIN, CECILE ROSE, ALVIN S. TEIRSTEIN, STEVEN E. WEINBERGER, HENRY YEAGER, REUBEN CHERNIACK, and the ACCESS RESEARCH GROUP

Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, Michigan

Despite reports of familial clustering of sarcoidosis, little empirical evidence exists that disease risk in family members of sarcoidosis cases is greater than that in the general population. To address this question, we estimated sarcoidosis familial relative risk using data on disease occurrence in 10,862 first- and 17,047 second-degree relatives of 706 age, sex, race, and geographically matched cases and controls who participated in the multicenter ACCESS (A Case- Control Etiology Study of Sarcoidosis) study from 1996 to 1999. Familial relative risk estimates were calculated using a logistic regression technique that accounted for the dependence between relatives. Sibs had the highest relative risk (odds ratio [OR] = 5.8; 95% confidence interval [CI] = 2.1-15.9), followed by avuncular relationships (OR = 5.7; 95% CI = 1.6-20.7), grandparents (OR = 5.2; 95% CI = 1.5-18.0), and then parents (OR = 3.8; 95% CI = 1.2-11.3). In a multivariate model fit to the parents and sibs data, the familial relative risk adjusted for age, sex, relative class, and shared environment was 4.7 (95% CI = 2.3-9.7). White cases had a markedly higher familial relative risk compared with African-American cases (18.0 versus 2.8; p = 0.098). In summary, a significant elevated risk of sarcoidosis was observed among first- and second-degree relatives of sarcoidosis cases compared with relatives of matched control subjects.




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