University of Florence, piazza di San Marco, 4, 50121, Florence, Italy.
University of Trieste, via dell'Istria, 65/1, 34100, Trieste, Italy.
Ital J Pediatr. 2018 Jun 28;44(1):74. doi: 10.1186/s13052-018-0517-6.
Sarcoidosis in pediatric age is uncommon and challenging diagnosis, because manifestations can be significantly variable and non-specific since it is a multisystem disease, and virtually any organ system may be involved.
In this report, we describe the case of a 12-year-old girl presenting with fatigue and weight loss, with a painless hepato-splenomegaly without additional clinical signs on physical examination. In our patient, once we had ruled out infections, malignancies and granulomatous diseases of childhood, we made diagnosis of sarcoidosis, finding suggestive histological features in two different tissues (liver and lymph nodes) with lung involvement.
Our case points out that pediatricians should consider sarcoidosis in the differential diagnosis in case of systemic symptoms, even in absence of other specific clinical clues, because they represent the most common clinical manifestations on presentation in children, in order to refer promptly the young patient to specialist evaluation.
儿童期结节病是一种罕见且具有挑战性的诊断,因为其表现可能非常多样化且非特异性,因为它是一种多系统疾病,几乎任何器官系统都可能受到影响。
在本报告中,我们描述了一例 12 岁女孩的病例,她表现为疲劳和体重减轻,伴有无痛性肝脾肿大,体格检查无其他临床体征。在我们的患者中,一旦排除了感染、恶性肿瘤和儿童期的肉芽肿性疾病,我们就诊断为结节病,在两个不同的组织(肝脏和淋巴结)中发现了提示性的组织学特征,同时伴有肺部受累。
我们的病例表明,儿科医生在出现全身症状时应考虑结节病的鉴别诊断,即使没有其他特定的临床线索,因为它们是儿童就诊时最常见的临床表现,以便及时将年轻患者转介给专家进行评估。