1
|
Ozer G, Ozcan HN, Gocmen R, Orhan D, Oguz B, Haliloglu M. Imaging Features of Pediatric Sarcoidosis. Radiographics 2024; 44:e230098. [PMID: 38096112 DOI: 10.1148/rg.230098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Sarcoidosis is a granulomatous inflammatory disease of uncertain cause. It occurs most commonly in young and middle-aged adults and less frequently in children; therefore, few data on pediatric sarcoidosis exist in the literature. The diagnosis and management of sarcoidosis remain challenging because of diverse and often nonspecific clinical and imaging findings. In addition, the clinical picture varies widely by age. Prepubertal and adolescent patients often present with adult-like pulmonary disease; however, early-onset sarcoidosis is typically characterized by the triad of arthritis, uveitis, and skin rash. Sarcoidosis is mostly a diagnosis of exclusion made by demonstrating noncaseating granulomas at histopathologic examination in patients with compatible clinical and radiologic findings. Although sarcoidosis often affects the lungs and thoracic lymph nodes, it can involve almost any organ in the body. The most common radiologic manifestation is pulmonary involvement, characterized by mediastinal and bilateral symmetric hilar lymphadenopathies with perilymphatic micronodules. Abdominal involvement is also common in children and often manifests as hepatomegaly, splenomegaly, and abdominal lymph node enlargement. Although neurosarcoidosis and cardiac sarcoidosis are rare, imaging is essential to the diagnosis of central nervous system and cardiac involvement because of the risky biopsy procedure and its low diagnostic yield due to focal involvement. Being familiar with the spectrum of imaging findings of sarcoidosis may aid in appropriate diagnosis and management. ©RSNA, 2023 Test Your Knowledge questions are available in the supplemental material.
Collapse
Affiliation(s)
- Gozde Ozer
- From the Departments of Radiology (G.O., H.N.O., R.G., B.O., M.H.) and Pathology (D.O.), Hacettepe University School of Medicine, Hacettepe M, Gevher Nesibe C, 06230 Altındag/Ankara, Turkey
| | - H Nursun Ozcan
- From the Departments of Radiology (G.O., H.N.O., R.G., B.O., M.H.) and Pathology (D.O.), Hacettepe University School of Medicine, Hacettepe M, Gevher Nesibe C, 06230 Altındag/Ankara, Turkey
| | - Rahsan Gocmen
- From the Departments of Radiology (G.O., H.N.O., R.G., B.O., M.H.) and Pathology (D.O.), Hacettepe University School of Medicine, Hacettepe M, Gevher Nesibe C, 06230 Altındag/Ankara, Turkey
| | - Diclehan Orhan
- From the Departments of Radiology (G.O., H.N.O., R.G., B.O., M.H.) and Pathology (D.O.), Hacettepe University School of Medicine, Hacettepe M, Gevher Nesibe C, 06230 Altındag/Ankara, Turkey
| | - Berna Oguz
- From the Departments of Radiology (G.O., H.N.O., R.G., B.O., M.H.) and Pathology (D.O.), Hacettepe University School of Medicine, Hacettepe M, Gevher Nesibe C, 06230 Altındag/Ankara, Turkey
| | - Mithat Haliloglu
- From the Departments of Radiology (G.O., H.N.O., R.G., B.O., M.H.) and Pathology (D.O.), Hacettepe University School of Medicine, Hacettepe M, Gevher Nesibe C, 06230 Altındag/Ankara, Turkey
| |
Collapse
|
2
|
Cannon L, Van Mater D, Van Mater H, Becker M. Eye Swelling and Weight Loss in an 18-year-old Adolescent. Pediatr Rev 2022; 43:350-352. [PMID: 35641446 DOI: 10.1542/pir.2020-004891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
3
|
Nathan N, Sileo C, Calender A, Pacheco Y, Rosental PA, Cavalin C, Macchi O, Valeyre D, Clement A. Paediatric sarcoidosis. Paediatr Respir Rev 2019; 29:53-59. [PMID: 30917882 DOI: 10.1016/j.prrv.2018.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/09/2018] [Indexed: 12/15/2022]
Abstract
Paediatric sarcoidosis is an extremely rare disease characterized by a granulomatous inflammation. The estimated incidence is 0.6-1.02/100,000 children, but in the absence of international registers, the disease is probably under-reported. Its pathophysiologic basis is not clearly understood but the current hypothesis is a combination of a genetic predisposition and an environmental exposure that could be either organic or mineral. Contrary to adult forms of the disease, general symptoms are often at the forefront at diagnosis. In its most frequent form, paediatric sarcoidosis is a multi-organ disorder affecting preferentially the lungs, the lymphatic system and the liver, but all organs can be affected. This review aims to provide an overview of current knowledge on sarcoidosis in children, providing a summary of the data available from cohort studies on the presentation, the management and the evolution of the disease in this specific population.
Collapse
Affiliation(s)
- Nadia Nathan
- Service de Pneumologie Pédiatrique et Centre de référence des maladies respiratoires rares, AP-HP, Hôpital Trousseau, Unité INSERM UMR-S933, Sorbonne Université, Paris, France.
| | - Chiara Sileo
- Service de Radiologie Pédiatrique, AP-HP, Hôpital Trousseau, Paris, France.
| | - Alain Calender
- Service de Génétique, CHU Lyon, Equipe EA7426 (PI3) Inflammation et immunité de l'épithélium respiratoire, Lyon, France.
| | - Yves Pacheco
- Service de Génétique, CHU Lyon, Equipe EA7426 (PI3) Inflammation et immunité de l'épithélium respiratoire, Lyon, France.
| | - Paul-André Rosental
- SLICOSIS Groupe, European Research Council (ERC)/SILICOSIS project, Centre for European Studies and Comparative Politics, Sciences Po, Paris, France.
| | - Catherine Cavalin
- SLICOSIS Groupe, European Research Council (ERC)/SILICOSIS project, Centre for European Studies and Comparative Politics, Sciences Po, Paris, France.
| | - Odile Macchi
- SLICOSIS Groupe, European Research Council (ERC)/SILICOSIS project, Centre for European Studies and Comparative Politics, Sciences Po, Paris, France.
| | - Dominique Valeyre
- AP-HP Service de pneumologie, Hôpital Avicenne, EA2363, Université Paris 13, Bobigny, France.
| | - Annick Clement
- Service de Pneumologie Pédiatrique et Centre de référence des maladies respiratoires rares, AP-HP, Hôpital Trousseau, Unité INSERM UMR-S933, Sorbonne Université, Paris, France.
| | | | | |
Collapse
|