Саркоидоз у детей: редко, но возможно. Клинический случай 5-летнего наблюдения ребенка с генерализованным саркоидозом

Abstract

Sarcoidoicle presents a clinical case of 5 years observation of a child with generalized sarcoidosis from 11 to 16 years old. The disease debuted with erythema nodosum of the legs, weakness. After 7 months the supraclavicular lymph nodes increase was found. Computed tomography of the chest organs revealed increased intrathoracic lymph nodes, small focal dissemination in the lungs, focal lesions of the spleen. Differential diagnosis between tuberculosis, lymphogranulomatosis, sarcoidosis was carried out. The final diagnosis is generalized sarcoidosis, active phase, involving the peripheral, intrathoracic lymph nodes, lungs, spleen and erythema nodosum of the legs. The diagnosis was based on clinical, laboratory and instrumental examination (computer tomogram) results, which revealed characteristic changes of intrathoracic lymph nodes and lungs. The morphological study of biopsy material (from supraclavicular lymph nodes) confirmed the diagnosis by the detection of granulomas with distinctive signs of sarcoidosis. The therapy with gradual decrease of methylprednisolone dose until the complete discontinuation of the drug was carried out within 13 months. In 2 months after the treatment initiation erythema nodosum of the legs resolution and positive radiological dynamics were noted. In 12 months focal lesions of the spleen disappeared. 3 years after the start of corticosteroid therapy clinical and radiological remission was diagnosed, which persisted for more than 4 years after stopping treatment.