[Early onset pediatric sarcoidosis, diagnostic problems].
Identifieur interne : 000545 ( France/Analysis ); précédent : 000544; suivant : 000546[Early onset pediatric sarcoidosis, diagnostic problems].
Auteurs : G. Deverrière [France] ; A. Flamans-Klein ; D. Firmin ; O. Azouzi ; P. Courville ; P. Le RouxSource :
- Archives de pediatrie : organe officiel de la Societe francaise de pediatrie [ 1769-664X ] ; 2012.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Sarcoidosis.
- Age of Onset, Child, Preschool, Humans, Male.
Abstract
Sarcoidosis, a chronic multisystem inflammatory granulomatous disorder of unknown origin, is a rare disease in children. Two distinct clinical presentations of sarcoidosis in childhood are known. Older children usually show multisystem disease, close to the adult manifestation, with lung infiltration and frequent hilar lymphadenopathy. Prior to the age of 5, sarcoidosis reveals more frequently with the classical triad of rash, arthritis, and uveitis. Due to non-specific clinical features and the lack of a specific test, recognizing sarcoidosis can be difficult in the pediatric population. Moreover, unlike in adults, lung involvement is rare in pediatric sarcoidosis. Given the lack of a definitive blood test, the World Association of Sarcoidosis and Other Granulomatous disorders (WASOG) only recommends dosing the serum angiotensin-converting enzyme (ACE). Its level is usually higher in children than in adults, but an increased ACE may help in the diagnosis. The gold standard is a biopsy specimen with typical epithelioid gigantocellular granuloma without caseating necrosis granuloma, after other disorders known to cause granulomatous disease have been reasonably excluded. We report here the case of a 4.5-year-old male with the history of polyarthritis and uveitis, considered first as juvenile rheumatoid arthritis, followed 5 years later by cutaneous involvement, which led to reconsidering the diagnosis. There were no pulmonary clinical findings. Histology provided the diagnosis of sarcoidosis. He then developed dependence on steroids. The lack of the classical triad delayed the diagnosis several years. This case shows the pediatric singularity of sarcoidosis, which needs to be known so that early and appropriate follow-up can be conducted.
DOI: 10.1016/j.arcped.2012.04.024
PubMed: 22652518
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: 000185
- to stream PubMed, to step Curation: 000185
- to stream PubMed, to step Checkpoint: 000185
- to stream Ncbi, to step Merge: 000317
- to stream Ncbi, to step Curation: 000317
- to stream Ncbi, to step Checkpoint: 000317
- to stream Main, to step Merge: 000606
- to stream Main, to step Curation: 000606
- to stream Main, to step Exploration: 000606
- to stream France, to step Extraction: 000545
Links to Exploration step
pubmed:22652518Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">[Early onset pediatric sarcoidosis, diagnostic problems].</title><author><name sortKey="Deverriere, G" sort="Deverriere, G" uniqKey="Deverriere G" first="G" last="Deverrière">G. Deverrière</name><affiliation wicri:level="3"><nlm:affiliation>Service des urgences pédiatriques, groupe hospitalier du Havre, 55 bis, rue Gustave-Flaubert, 76600 Le Havre, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des urgences pédiatriques, groupe hospitalier du Havre, 55 bis, rue Gustave-Flaubert, 76600 Le Havre</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Le Havre</settlement></placeName></affiliation></author><author><name sortKey="Flamans Klein, A" sort="Flamans Klein, A" uniqKey="Flamans Klein A" first="A" last="Flamans-Klein">A. Flamans-Klein</name></author><author><name sortKey="Firmin, D" sort="Firmin, D" uniqKey="Firmin D" first="D" last="Firmin">D. Firmin</name></author><author><name sortKey="Azouzi, O" sort="Azouzi, O" uniqKey="Azouzi O" first="O" last="Azouzi">O. Azouzi</name></author><author><name sortKey="Courville, P" sort="Courville, P" uniqKey="Courville P" first="P" last="Courville">P. Courville</name></author><author><name sortKey="Le Roux, P" sort="Le Roux, P" uniqKey="Le Roux P" first="P" last="Le Roux">P. Le Roux</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2012">2012</date><idno type="RBID">pubmed:22652518</idno><idno type="pmid">22652518</idno><idno type="doi">10.1016/j.arcped.2012.04.024</idno><idno type="wicri:Area/PubMed/Corpus">000185</idno><idno type="wicri:Area/PubMed/Curation">000185</idno><idno type="wicri:Area/PubMed/Checkpoint">000185</idno><idno type="wicri:Area/Ncbi/Merge">000317</idno><idno type="wicri:Area/Ncbi/Curation">000317</idno><idno type="wicri:Area/Ncbi/Checkpoint">000317</idno><idno type="wicri:Area/Main/Merge">000606</idno><idno type="wicri:Area/Main/Curation">000606</idno><idno type="wicri:Area/Main/Exploration">000606</idno><idno type="wicri:Area/France/Extraction">000545</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Early onset pediatric sarcoidosis, diagnostic problems].</title><author><name sortKey="Deverriere, G" sort="Deverriere, G" uniqKey="Deverriere G" first="G" last="Deverrière">G. Deverrière</name><affiliation wicri:level="3"><nlm:affiliation>Service des urgences pédiatriques, groupe hospitalier du Havre, 55 bis, rue Gustave-Flaubert, 76600 Le Havre, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des urgences pédiatriques, groupe hospitalier du Havre, 55 bis, rue Gustave-Flaubert, 76600 Le Havre</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region><settlement type="city">Le Havre</settlement></placeName></affiliation></author><author><name sortKey="Flamans Klein, A" sort="Flamans Klein, A" uniqKey="Flamans Klein A" first="A" last="Flamans-Klein">A. Flamans-Klein</name></author><author><name sortKey="Firmin, D" sort="Firmin, D" uniqKey="Firmin D" first="D" last="Firmin">D. Firmin</name></author><author><name sortKey="Azouzi, O" sort="Azouzi, O" uniqKey="Azouzi O" first="O" last="Azouzi">O. Azouzi</name></author><author><name sortKey="Courville, P" sort="Courville, P" uniqKey="Courville P" first="P" last="Courville">P. Courville</name></author><author><name sortKey="Le Roux, P" sort="Le Roux, P" uniqKey="Le Roux P" first="P" last="Le Roux">P. Le Roux</name></author></analytic><series><title level="j">Archives de pediatrie : organe officiel de la Societe francaise de pediatrie</title><idno type="eISSN">1769-664X</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age of Onset</term><term>Child, Preschool</term><term>Humans</term><term>Male</term><term>Sarcoidosis (diagnosis)</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Sarcoidosis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age of Onset</term><term>Child, Preschool</term><term>Humans</term><term>Male</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Sarcoidosis, a chronic multisystem inflammatory granulomatous disorder of unknown origin, is a rare disease in children. Two distinct clinical presentations of sarcoidosis in childhood are known. Older children usually show multisystem disease, close to the adult manifestation, with lung infiltration and frequent hilar lymphadenopathy. Prior to the age of 5, sarcoidosis reveals more frequently with the classical triad of rash, arthritis, and uveitis. Due to non-specific clinical features and the lack of a specific test, recognizing sarcoidosis can be difficult in the pediatric population. Moreover, unlike in adults, lung involvement is rare in pediatric sarcoidosis. Given the lack of a definitive blood test, the World Association of Sarcoidosis and Other Granulomatous disorders (WASOG) only recommends dosing the serum angiotensin-converting enzyme (ACE). Its level is usually higher in children than in adults, but an increased ACE may help in the diagnosis. The gold standard is a biopsy specimen with typical epithelioid gigantocellular granuloma without caseating necrosis granuloma, after other disorders known to cause granulomatous disease have been reasonably excluded. We report here the case of a 4.5-year-old male with the history of polyarthritis and uveitis, considered first as juvenile rheumatoid arthritis, followed 5 years later by cutaneous involvement, which led to reconsidering the diagnosis. There were no pulmonary clinical findings. Histology provided the diagnosis of sarcoidosis. He then developed dependence on steroids. The lack of the classical triad delayed the diagnosis several years. This case shows the pediatric singularity of sarcoidosis, which needs to be known so that early and appropriate follow-up can be conducted.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Haute-Normandie</li><li>Région Normandie</li></region><settlement><li>Le Havre</li></settlement></list><tree><noCountry><name sortKey="Azouzi, O" sort="Azouzi, O" uniqKey="Azouzi O" first="O" last="Azouzi">O. Azouzi</name><name sortKey="Courville, P" sort="Courville, P" uniqKey="Courville P" first="P" last="Courville">P. Courville</name><name sortKey="Firmin, D" sort="Firmin, D" uniqKey="Firmin D" first="D" last="Firmin">D. Firmin</name><name sortKey="Flamans Klein, A" sort="Flamans Klein, A" uniqKey="Flamans Klein A" first="A" last="Flamans-Klein">A. Flamans-Klein</name><name sortKey="Le Roux, P" sort="Le Roux, P" uniqKey="Le Roux P" first="P" last="Le Roux">P. Le Roux</name></noCountry><country name="France"><region name="Région Normandie"><name sortKey="Deverriere, G" sort="Deverriere, G" uniqKey="Deverriere G" first="G" last="Deverrière">G. Deverrière</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/France/explor/LeHavreV1/Data/France/Analysis
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000545 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/France/Analysis/biblio.hfd -nk 000545 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/France
|area= LeHavreV1
|flux= France
|étape= Analysis
|type= RBID
|clé= pubmed:22652518
|texte= [Early onset pediatric sarcoidosis, diagnostic problems].
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/France/Analysis/RBID.i -Sk "pubmed:22652518" \
| HfdSelect -Kh $EXPLOR_AREA/Data/France/Analysis/biblio.hfd \
| NlmPubMed2Wicri -a LeHavreV1
| This area was generated with Dilib version V0.6.25. |  |