Early-Onset Childhood Sarcoidosis, Manifesting as Juvenile Idiopathic Arthritis: A Case Report

Abstract

Background: Childhood Sarcoidosis is a rare multisystemic granulomatous disorder of unknown etiology. Two distinct forms of Sarcoidosis exist in children. Older children usually present with a multisystem disease similar to the adult manifestations, with frequent hilar lymphadenopathy and pulmonary infiltrations. Early-onset childhood Sarcoidosis is a unique form of the disease characterized by the triad of rash, uveitis, and arthritis in children before four years of age. Because of similarities in clinical presentation childhood sarcodosis can be easily confused with idiopathic arthritis. The diagnosis of Sarcoidosis is confirmed by demonstrating a typical noncaseating granuloma on a biopsy specimen. Case description: We describe an interesting case of early onset childhood sarcodosis who was initially diagnosed and treated as having juvenile idiopathic arthritis (JIA). A 6years old Libyan boy referred to Tripoli Children Hospital rheumatology clinic at the age of 2 years, with 5 months history of multiple joints pain and swelling affecting small as well as big joints. Associated with skin rash and intermittent fever Conclusion: We draw attention to early-onset Sarcoidosis as possible differential diagnosis to juvenile idiopathic arthritis and we recommend prompt skin biopsy to differentiate between these conditions.