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Background: There is a paucity of evidence on impact of a delay in Cardiac Sarcoidosis (CS) diagnosis after high-grade atrioventricular-block (AVB) and this study aims to fill this void., Methods: Consecutive CS patients (n = 77) with high grade AVB referred to one specialist hospital in London between February 2007 to February 2023 were retrospectively reviewed. The median time from AVB to diagnosing CS (112 days) was used to define the Early (n = 38) and Late (n = 39) cohorts. The primary endpoint was a composite of all-cause mortality, cardiac transplantation, ventricular arrhythmic events or heart failure hospitalisation. Secondary endpoints included difference in maintenance prednisolone dose, need for cardiac device upgrade and device complications., Results: The mean age of the cohort was 54.4 (±10.6) years of whom 64 % were male and 81 % Caucasian. After a mean follow up of 54.9 (±45.3) months, the primary endpoint was reached by more patients from the Late cohort (16/39 vs. 6/38, p = 0.02; multivariable HR 6.9; 95 %CI 1.5-32.2, p = 0.01). Early Group were more likely to have received an Implantable Cardioverter Defibrillator or Cardiac Resynchronisation Therapy-defibrillator as index device after AVB (19/38 vs. 6/39; p < 0.01) and had fewer device upgrades (19/38 vs. 30/39, p = 0.01) and a trend towards fewer device complications (1 vs. 5, p = 0.20). The maintenance dose of prednisolone was significantly higher in Late Group [20.7(±9.7) mg vs. 15.3(±7.9) mg, p = 0.02]., Conclusion: A late diagnosis of CS was associated with more adverse events, a greater probability of needing a device upgrade and required higher maintenance steroid dose., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The records of 91 patients who conformed to rigid criteria for the diagnosis of sarcoidosis were studied. These included 36 patients of West Indian and 47 of Caucasian origin. Comparison of these two groups showed a significantly later age of onset in the West Indians, who were also more liable to present with respiratory symptoms, particularly chest discomfort, to have eye involvement and palpable lymphadenopathy and to have a more disseminated disease than the Caucasian group. However, Caucasians were far more likely to have erythema nodosum. There was a tendency for the onset of symptoms in the whole group to occur between November to February. Differences in sarcoidosis between ethnic groups within the same geographical area suggest variable host responses which may be dependant on their immunological response. The later age of onset of sarcoidosis seen the West Indians might be explained by their later exposure to an environmental transmissible agent.

During the first 10 years (1963-74) of a new Medical Ophthalmology Unit, 368 of 3,930 admissions had endogenous uveitis, anterior in 215 (58 per cent.), posterior in 65 (18 per cent.), and generalized in 88 (24 per cent.). Acute uveitis in 153 patients tended to have a short course counted in months, whereas in 215 with chronic uveitis the condition was measured over years, punctuated by relapses. Sex distribution was equal. At the time of initial presentation, 60 per cent. of patients were aged 20 to 40 years, 8 per cent. were under 20, and 10 per cent. were over 60 years of age.