Sarcoidosis in children: Personal observations on age distribution

Kendig, Edwin L.

doi:10.1002/ppul.1950060202

Cited by 21 publications

(7 citation statements)

References 25 publications

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“…In our series, most of cases occurred in patients aged 10-14 years; five patients had onset before the age of 5 years and were diagnosed with early-onset childhood sarcoidosis (EOCS). The most reported childhood cases have occurred in patients aged 13 to 15 years [4,5]. In the present series, the male/female gender ratio was 1, and in the majority of pediatric series, the incidence of sarcoidosis is similar for both genders [3].…”

Section: Discussionmentioning

confidence: 65%

Childhood sarcoidosis: Louisiana experience

et al. 2015

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A retrospective chart review was conducted to detect patients with sarcoidosis seen by pediatric rheumatology service from the period of 1992 to 2013 at Children's hospital of New Orleans. Twenty-seven patients were identified. The average duration of symptoms before diagnosis was 5 (range 1-120) months. Five patients had onset before the age of 5 years and were diagnosed with early-onset sarcoidosis. The most common manifestations at presentation were constitutional symptoms (62 %) followed by ocular (38 %). During the course of illness, 19/27 (70 %) had multiorgan involvement. Common manifestations included uveitis/iritis (77 %), fever (50 %), hilar adenopathy (42 %), arthritis (31 %), peripheral lympadenopathy (31 %), hepatosplenomegaly (31 %), parenchymal lung disease (27 %), and skin rash (19 %). Unusual manifestations included granulomatous bone marrow disease (3 cases), hypertension (2), abdominal aortic aneurysm (large vessel vasculitis; 1), granulomatous hepatitis (1), nephrocalcinosis (1), membranous nephropathy (1), refractory granulomatous interstitial nephritis with recurrence in transplanted kidney (1), CNS involvement (2), parotid gland enlargement (1), and sensorineural hearing loss (1). Biopsy specimen was obtained in 21/27 (77 %) patients, and demonstration of noncaseating granuloma associated with negative stains for mycobacteria and fungi was seen in 18 patients. Elevated angiotensin-converting enzyme level was seen in 74 % of patients. Treatment with oral prednisone was initiated in symptomatic patients with significant clinical improvement. Low-dose methotrexate (MTX) 10-15 mg/m(2)/week orally, as steroid-sparing agent, was administered in 14 patients. Other immunomodulators included cyclophosphamide (2 patients), etanercept (2), infliximab (2), mycophenolate mofetil (1), and tacrolimus (1). Childhood sarcoidosis is prevalent in Louisiana. Most of the affected children present with a multisystem disease associated with manifestations similar to those of adult patients. Low-dose MTX seems to be effective, steroid sparing, and safe adjunct to treat sarcoidosis with multiorgan involvement. Early-onset disease is less common and associated with increased morbidity, flares, and poor prognosis.

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Section: Discussionmentioning

confidence: 65%

Childhood sarcoidosis: Louisiana experience

et al. 2015

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“…Sarcoidosis in children is usually diagnosed at 12-15 y of age (6,7,19) and the incidence of clinically recognized sarcoidosis is low in Danish children. As in adults (3), childhood cases may remain undetected, as the disease may take a subclinical, asymptomatic course.…”

Section: Discussionmentioning

confidence: 99%

Childhood sarcoidosis in Denmark 1979-1994: incidence, clinical features and laboratory results at presentation in 48 children

Milman

Byg

2004

Acta Paediatrica

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“…The incidence and prevalence of clinically recognized sarcoidosis is low in Danish children. Sarcoidosis in children is typically diagnosed between 13 and 15 y of age (8). As in adults (9) many childhood cases probably remain undiagnosed, since the disease may take a subclinical, asymptomatic course.…”

Section: Epidemiologymentioning

confidence: 99%

Sarcoidosis in children. Epidemiology in Danes, clinical features, diagnosis, treatment and prognosis

Milman

1998

Acta Paediatrica

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This paper reviews current knowledge of childhood sarcoidosis with regard to the epidemiology in Danes, clinical presentation, diagnostic procedures, treatment and prognosis. Sarcoidosis is a granulomatous disease of unknown aetiology, with multiorgan involvement. The diagnosis is confirmed by the demonstration of epitheloid cell granulomas in tissue biopsy specimens. During the period 1980‐92, three cases of childhood sarcoidosis were recorded in Copenhagen County, which has a total population of 610,000. The approximate incidence of clinically recognized sarcoidosis in Danish children younger than 15 y of age was 0.22–0.27/100,000 children per year, corresponding to approximately three new cases in Denmark each year. The true incidence is unknown, since the disease is often asymptomatic and resolves without a clinical diagnosis being made. In children younger than 5 y of age, the disease is characterized by involvement of skin, eyes and joints, whereas in older children involvement of lungs, lymph nodes and eyes predominate. The mainstay of treatment consists of oral corticosteroids. The risk/benefit ratio of using long‐term corticosteroids needs to be evaluated in each individual patient. Some patients may benefit from additional therapy with methotrexate. The long‐term prognosis is not well established, but it seems to be poorer in children younger than 5y. Older children appear to have as favourable a prognosis as young adults.

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Sarcoidosis in children: Personal observations on age distribution

Cited by 21 publications

References 25 publications

Childhood sarcoidosis: Louisiana experience

Childhood sarcoidosis: Louisiana experience

Childhood sarcoidosis in Denmark 1979-1994: incidence, clinical features and laboratory results at presentation in 48 children

Sarcoidosis in children. Epidemiology in Danes, clinical features, diagnosis, treatment and prognosis

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