The puzzling clinical spectrum and course of juvenile sarcoidosis

Abstract

Sarcoidosis in childhood is recognized as a systemic disease affecting various organs and having diverse clinical course depending on the age of onset.

The Diversity of Juvenile Sarcoidosis Symptoms

“…In children, during their first four year period of life florid manifestations seem to constitute a separate entity. In older children sarcoidosis presents as a multisystem disorder often accompanied by non specific, constitutional symptoms at onset (Fretzayas et al, 2011). Lung is the most common organ involved at this age group (Fretzayas et al, 2011), although this was not the case with our patient.…”

“…In older children sarcoidosis presents as a multisystem disorder often accompanied by non specific, constitutional symptoms at onset (Fretzayas et al, 2011). Lung is the most common organ involved at this age group (Fretzayas et al, 2011), although this was not the case with our patient. It should be noted that in a Danish report only 10% of children with sarcoidosis had normal chest-X-ray (Hoffmann et al, 2004).…”

“…The differential diagnosis of sarcoidosis is extremely broad (Shetty and Gedalia, 2008;Fretzayas et al, 2011) and includes juvenile idiopathic arthritis, lymphoma, other interstitial lung disease as well as Loefgren's and Mikulicz diseases. Certain infectious entities attributed to mycobacteria and fungi should also be ruled out when granulomatous lesions are found on lung biopsy.…”

“…In case of hepatic granulomas, cat scratch disease and granulomatous hepatitis should be excluded as well. It should be noted that in children younger than 4 years of age early onset sarcoidosis is quite rare and has a distinct triad of skin, joint and eye disorders without lung involvement (Shetty and Gedalia, 2008;Fretzayas et al, …”

An 11-Year-Old Boy with Diffuse Pulmonary Infiltrates and Respiratory Failure

“…Sarcoidosis in children has no gender predominance (as opposed to adults, where its slightly more common in women), but there is a higher prevalence in African-Americans (40 per 100,000) than in whites (5 per 100,000). 1 The mean age of onset is 10.6 years and the incidence has been estimated to be 0.22 to 0.27 per 100,000 children younger than age 15 years. 2 The prognosis seems to be worse in younger children and in those with multisystem involvement.…”