Reggie White's Disease Stealthy And Fatal - Sarcoidosis ?
DGH
Reggie White probably died of a mysterious inflammatory disease of
unknown origin that can strike any organ in the body, exist without
detection and disappear without treatment in many cases, according to a
preliminary autopsy report.
Sarcoidosis in White's lungs and heart was the likely trigger that
"resulted in a fatal cardiac arrhythmia," Dr. Mike Sullivan, medical
examiner of Mecklenburg County, North Carolina, said Monday. "Sleep
apnea may have been a contributing factor."
Sullivan's is the jurisdiction where White died at 7:51 a.m. Sunday
after being taken from his home in Cornelius, N.C., to Presbyterian
Hospital in Huntersville, North Carolina. He was 43.
Though sarcoidosis is fatal in only 5 percent of cases and is reported
in only one of every 2,500 U.S. residents, its insidious nature
apparently has been revealed again in White's case.
Two years ago, WMAQ-Ch. 5 sports anchor and reporter Darrian Chapman
died of what appeared to be a heart attack. But three months later, the
cause of death was determined to be cardiac sarcoidosis.
"Fifty percent of cardiac sarcoidosis cases are only diagnosed after
death," said Andrea Wilson, president of the Foundation for Sarcoidosis
Research in Chicago. She has the disease in her lungs, heart, brain and
joints, takes medication for it three times a day and says she was
misdiagnosed for eight years before it was revealed in a chest X-ray.
Dr. Terrence Demos, a radiologist at Loyola University Medical Center
in Maywood, said, "I've seen hundreds of cases of sarcoidosis in
X-rays."
But while 95 percent of people with the disease have an abnormal chest
X-ray that provides a clue, Demos said: "Most people have no symptoms,
most don't require any treatment, and there is no one way to make a
diagnosis of sarcoidosis. Mostly it is a process of elimination, ruling
out other diseases."
The lethal possibility of sarcoidosis occurs when it affects the
heart's electrical conduction system, "interfering with heart rhythm,"
Demos said.
Loyola has done more than a dozen lung transplants "for end-stage lung
disease due to sarcoidosis," he said.
A family spokesman said White had sarcoidosis for several years and
that it affected his sleep but did not say whether he was undergoing
any treatment. The American Lung Association's Web site describes the
disease as "characterized by the presence of granulomas, small areas of
inflamed cells" but "most frequently found in the lungs."
Symptoms may include rashes, fever, swollen ankles, fatigue, weakness,
weight loss, shortness of breath and a persistent cough. But the
association says: "These symptoms are common in many other lung
diseases, so diagnosis may be difficult."
While the disease has no single or similar pattern and is not
contagious, researchers have found it more prevalent and often more
serious in African-Americans in the U.S., Demos said.
In a study of 302 NFL players published in the New England Journal of
Medicine two years ago, researchers found that sleep apnea, a disorder
that halts breathing intermittently during sleep, was more widespread
among young, presumably fit athletes than was commonly reported among
middle-aged or older men. The average age of the players in the study
was 25. The highest percentage of apnea was found among the largest,
heaviest linemen.
No clear connection has been established between sarcoidosis and sleep
apnea, but a University of Cincinnati study in 1997 found that patients
with sarcoidosis are at increased risk for sleep apnea.
It probably will be weeks before a final cause of death is given for
White, a defensive end who was twice named NFL defensive player of the
year and elected to the Pro Bowl a record 13 consecutive times from
1986-98.
Chicago Tribune