Slide 1: Q: New York City firefighters who helped in the September 11th relief should be considered at risk for which interstitial lung disease?
Slide 2: A: Sarcoidosis. In the yera after 9/11, the incidence of sarcoidosis rose 6x in NYC firefighters.
Slide 3: The pathogenesis of sarcoidosis is complex and not well-understood, but may include presentation of an unidentified antigen (found in the 9/11 debris) to CD4+ T-cells, which then recruit Th1 and Th2 cells to form granulomas.
Slide 4: Other pulmonary diseases that have been linked to 9/11 include: asthma, reactive airways dysfunction syndrome (RADS), one report or acute eosinophilic pneumonia (AEP).
Slide 5: World Trade Center (WTC)-related sarcoidosis appears to have similar radiographic features as typical sarcoidosis, with hilar lymphadenopathy and upper lung zone nodules. However, there is a higher prevalence of extrapulmonary sarcoidosis, including cardiac sarcoidosis and arthropathy.
- Izbicki G, Chavko R, Banauch GI, et al. World Trade Center “sarcoid-like” granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest. 2007 May;131(5):1414-23. Epub 2007 Mar 30. PMID 17400664.
- Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007 Nov 22;357(21):2153-65. PMID 18032765.
- Girvin F, Zeig-Owens R, Gupta D, et al. Radiologic Features of World Trade Center-related Sarcoidosis in Exposed NYC Fire Department Rescue Workers. J Thorac Imaging. 2016 Sep;31(5):296-303. PMID 27442523.
- Hena KM, Yip J, Jaber N, et al. Clinical Course of Sarcoidosis in World Trade Center-Exposed Firefighters. Chest. 2018 Jan;153(1):114-123. PMID 29066387.