Pediatric uveitis secondary to probable, presumed, and biopsy-proven sarcoidosis.
OBJECTIVE
To describe pediatric patients with uveitis diagnosed as having sarcoidosis.


METHODS
Medical records of pediatric patients evaluated between 1987 and 2008 were reviewed to identify those with ocular inflammation in whom a diagnosis of sarcoidosis was considered. A classification system including ocular findings and results of laboratory testing was devised and used to classify likelihood of sarcoidosis.


RESULTS
Four hundred sixty children younger than 17 years were evaluated. Based on the classification system designed, 13 patients (2.8%) had probable, presumed, or definite sarcoidosis. The mean age was 11.6 years (range: 5 to 16 years). Elevated angiotensin-converting enzyme was measured in 6 patients and lysozyme in 5 patients. Five of 12 patients in whom chest imaging was performed had signs of sarcoidosis. Anterior segment involvement was non-granulomatous more often than granulomatous. Seven patients had multifocal choroiditis and 4 patients had retinal periphlebitis.


CONCLUSIONS
Ocular sarcoidosis is uncommon in children, even at a tertiary referral center. Pulmonary involvement was detected in slightly less than half of the patients who had imaging, in contrast to previous reports of almost universal lung involvement in children 8 to 15 years old. The classification system of presumed, probable, and definite sarcoidosis presented may be useful in clinical practice.
Choi
Daniel E
DE
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.
Birnbaum
Andrea D
AD
Oh
Frederick
F
Tessler
Howard H
HH
Goldstein
Debra A
DA
D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000150:complications* / Q000175:diagnosis / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D009113:Muramidase / Q000097:blood; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000201:enzymology; D014605:Uveitis / Q000175:diagnosis / Q000201:enzymology / Q000209:etiology*
D009113:Muramidase; D007703:Peptidyl-Dipeptidase A