Clinical Profile and Outcome of Pediatric Sarcoidosis

Abstract

To document clinical features and outcome of children with sarcoidosis. Case records of 18 children (mean (SD) age 9 (2.2) years) diagnosed with sarcoidosis between 2006 and 2016 were reviewed. All children were followed up every 2-3 months and monitored for clinical and laboratory parameters. Their treatment and outcome were recorded. Clinical features at the time of diagnosis were fever (83%), uveitis (50%), difficulty in breathing (44%), hepatosplenomegaly, weight loss, arthritis and peripheral adenopathy. Imaging findings included: hilar adenopathy (94%), abdominal nodes (50%) and pulmonary infiltrates (44%). All children were treated with steroids (range 6-12 months) and weekly low dose oral methotrexate. All patients showed significant improvement over a mean (SD) duration of follow-up of 3.1 (0.9) years, as assessed by resolution of clinical symptoms, and improvement in spirometry parameters, erythrocyte sedimentation rate, and serum angiotensin converting enzyme levels. Children with sarcoidosis seem to respond well to systemic steroids and low dose methotrexate. Delayed diagnosis and ocular involvement are probably associated with poor outcome.