Lymphopenia as a predictor of sarcoidosis in patients with uveitis

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Abstract

Aims

To investigate the hypothesis that lymphopenia is an independent predictor of sarcoidosis in new patients presenting with uveitis.

Patients and methods

Retrospective case–control study of 112 patients with sarcoidosis-associated uveitis (SAU) against 398 controls with other forms of uveitis.

Results

Of the patients with SAU, 30/112 (26.8%) had significant lymphopenia (<1.0×109/L), compared with 24/398 (6.0%) for other uveitis (p≤0.0001, OR 5.7 (95% CI 3.2 to 10.3)). The mean lymphocyte count for patients with SAU was 1.43 vs 2.04 for other uveitis (p≤0.0001). Logistic regression modelling using diagnosis of SAU as the independent variable identified age, ACE levels and lymphocyte count as independent predictors of SAU. A new patient with uveitis with significant lymphopenia has a risk of sarcoidosis (from this parameter alone) of 31.6%.

Conclusions

Significant lymphopenia (<1.0×109/L) is an independent predictor of sarcoidosis in new patients presenting with uveitis. We recommend that diagnostic criteria for SAU should be modified to include this phenomenon.

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