Sarcoidosis presenting as bilateral lacrimal gland swelling: a pediatric case report
Margaret S Powell1, Ashley W Cross2, Jared Tallo3
1Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison, WI, USA. margaret.s.brown@gmail.com.
Insights
Pediatric sarcoidosis can mimic other conditions, initially presenting as papillary conjunctivitis. This case highlights its potential to cause bilateral lacrimal gland swelling without systemic involvement.
Area of Science:
- Ophthalmology
- Pediatrics
- Rheumatology
Background:
- Sarcoidosis is a multisystem inflammatory disease characterized by noncaseating granulomas.
- Pediatric sarcoidosis is rare and can present with diverse clinical manifestations.
- Ocular involvement is common in sarcoidosis, affecting various ocular structures.
Observation:
- A 10-year-old female presented with symptoms suggestive of allergic conjunctivitis.
- Initial treatment for allergic conjunctivitis provided only temporary relief.
- The patient subsequently developed significant bilateral eyelid swelling and palpable lacrimal gland enlargement.
Findings:
- Lacrimal gland biopsy revealed noncaseating granulomas, confirming sarcoidosis.
- Systemic workup excluded other organ involvement.
- The case demonstrated an unusual presentation of pediatric sarcoidosis.
Implications:
- This case underscores the importance of considering sarcoidosis in pediatric patients with persistent or atypical ocular inflammation.
- Early diagnosis and appropriate management are crucial to prevent potential complications.
- Ophthalmologists should be aware of the varied presentations of sarcoidosis in children.
Background:
To describe a case of pediatric sarcoidosis which initially presented as papillary conjunctivitis before manifesting as bilateral lacrimal gland swelling without other known systemic involvement.
Case Presentation:
A 10-year-old female presented to the pediatric ophthalmology clinic with complaints of bilateral eyelid swelling, tearing and itching for approximately 1 month. Her history and exam were most consistent with allergic conjunctivitis, for which she was started on a standard topical regimen. Despite initial improvement, she re-presented with significantly worsened eyelid swelling and minimal allergic symptoms. Enlargement of the lacrimal glands were palpable at this time. Lacrimal gland biopsy was obtained which demonstrated noncaseating granulomas. Systemic workup did not reveal evidence of disease involvement elsewhere.
Conclusions:
Sarcoidosis in the pediatric population may present in a myriad of ways and is well-known to mimic other disease entities. We present a case of pediatric sarcoidosis which presented initially as papillary conjunctivitis before manifesting as bilateral lacrimal gland swelling without systemic involvement.
