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.


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  • 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.
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