An unusual case of childhood sarcoidosis

Abstract

SummarySarcoidosis is a systemic granulomatous disease of unknown etiology that may affect many systems, mainly lungs. Most of the patients present at stages I and II lung involvement. Pulmonary infiltrates without hilar lymphadenopathy (state III) rarely occurs. Extrapulmonary organ involvement is common in pediatric sarcoidosis. The aim of this report is to present an unusual case of childhood sarcoidosis with stage III lung involvement without any extrapulmonary organ involvement. A 7-year-old girl presented with the complaints of malaise, fatigue, weight loss and dyspnea. There was patchy, bilateral ground glass view at high resolution computer tomography. Video assisted thoracoscopic lung biopsy was performed and histopathological examination showed nonnecrotising epitheloid-cell granulomas with giant cells. She did not have any hilar or extrapulmonary organ involvement and pulmonary sarcoidosis at stage III was diagnosed. Sarcoidosis should be considered in the differential diagnosis of children with interstitial lung disease.

Difficulties of differential diagnosis of sarcoidosis and lymphoproliferative disease

“…Исследование уровня интерферона-гамма на антигены Mycobacterium tuberculosis complex в крови (квантифероновый тест) рекомендуется детям и взрослым, как альтернатива кожным тестам с туберкулином, и при саркоидозе дают, как правило, отрицательный результат [136,149,150].…”

Childhood Sarcoidosis mimicking Tuberculosis:A case report

“…It rarely affects children, with an incidence of 1/100 000 in children aged 15 years or under and 0.06/100 000 in children under 4 years of age 1 . On histopathology, the classic findings are noncaseating granulomas 2 , but early-onset (<5 years of age) sarcoidosis is usually characterized by the clinical triad of ocular, skin, and joint involvement without typical pulmonary disease 3 . The five stages of sarcoidosis, based on the extent of pulmonary involvement are: stage 0 (normal chest x-ray), stage I (hilar lymphadenopathy only), stage II (hilar lymphadenopathy and pulmonary infiltrates), stage III (pulmonary infiltrates without lymph node enlargement), and stage IV (advanced fibrosis without lymph node enlargement).…”

“…The five stages of sarcoidosis, based on the extent of pulmonary involvement are: stage 0 (normal chest x-ray), stage I (hilar lymphadenopathy only), stage II (hilar lymphadenopathy and pulmonary infiltrates), stage III (pulmonary infiltrates without lymph node enlargement), and stage IV (advanced fibrosis without lymph node enlargement). Stages I and II are the most common 3 .…”