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Sarcoidosis: A Pediatric Perspective

Department of Pediatrics, Louisiana State University Medical Center and, Children's Hospital of New Orleans, Louisiana

Abraham Gedalia, MD

Department of Pediatrics, Louisiana State University Medical Center and, Children's Hospital of New Orleans, Louisiana; Department of Pediatrics, Division of Pediatric Rheumatology, LSU Medical Center, 1542 Tulane Avenue, T8-1, New Orleans, LA 70112

Childhood sarcoidosis is a rare multisystemic granulomatous disease of unknown etiology. The clinical presentation can vary greatly depending upon the organs involved. Two distinct forms of sarcoidosis exist in children. Older children usually present with a multisystem disease similar to the adult manifestation, with frequent hilar lymphadenopathy and pulmonary infiltration. Early-onset childhood sarcoidosis is a unique form of the disease characterized by the triad of rash, uveitis, and arthritis in patients presenting before age 4 years. The diagnosis of sarcoidosis is confirmed by demonstrating a typical noncaseating granuloma on a biopsy specimen. The current therapy of choice for childhood sarcoidosis with multisystem involvement is corticosteroids. Methotrexate given orally in low doses is effective and safe and has steroid-sparing properties.

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