Childhood Sarcoidosis Involving Joints and Kidneys

So uncommon are some diseases and atypical their manifestations that failure to appreciate them and recognize their importance may lead to unduly prolonged studies, unnecessary treatment, or irreversible damage. Sarcoidosis is such a disease. Sarcoidosis, a nonspecific syndrome characterized by "the presence, in any organ or tissue, of epithelioid cells and tubercles with inconspicuous necrosis or without necrosis, and by a chronic course," is uncommon among children. Though there are over 200 cases reported in patients under 15 years of age, this number is only a small proportion of the number of cases in adults. 1-8 Patients with childhood sarcoidosis frequently have clinical features that are different from those seen in adults. 8,9 Even though transient polyarthritis has been reported in from 6% to 25% of adult patients, 7,9-12 it occurs only rarely in children. North and co-workers 17,18 compiled four such cases from the literature 13-16 and added six