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Renovascular and growth effects of childhood sarcoid
K P Morris1, M G Coulthard, P J Smith
1Department of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne.
Insights
Early onset sarcoidosis in a boy mimicked juvenile arthritis, affecting kidneys and eyes. Treatment with azathioprine, steroids, and hormone therapy managed severe symptoms and improved outcomes.
Area of Science:
- Pediatric Rheumatology
- Nephrology
- Ophthalmology
Background:
- Sarcoidosis is a rare multisystem inflammatory disease.
- Early onset sarcoidosis is exceptionally uncommon and can mimic other pediatric rheumatic conditions.
- Juvenile chronic arthritis is a common differential diagnosis in children presenting with inflammatory symptoms.
Observation:
- A pediatric patient presented with symptoms suggestive of juvenile chronic arthritis.
- The patient was diagnosed with early onset sarcoidosis.
- Key affected systems included the kidneys, eyes, and growth/pubertal development.
Findings:
- Renal granulomas led to severe hypertension and renal impairment, responsive to azathioprine and corticosteroids.
- Severe uveitis resulted in significant visual impairment.
- Impaired growth and delayed puberty, previously undescribed in pediatric sarcoidosis, were observed.
Implications:
- This case highlights sarcoidosis as a critical differential diagnosis in pediatric rheumatic diseases.
- Early diagnosis and multidisciplinary management are crucial for optimizing outcomes in pediatric sarcoidosis.
- The findings expand the known clinical spectrum of childhood sarcoidosis, including endocrine and growth disturbances.
Abstract:
A boy developed early onset sarcoidosis, an extremely rare mimic of juvenile chronic arthritis. Renal granulomas caused severe hypertension and renal impairment, which was controlled by azathioprine and steroids. Severe uveitis caused visual impairment. Impaired growth and delayed puberty, not previously described in childhood sarcoidosis, required growth hormone and testosterone treatment.