title: The puzzling clinical spectrum and course of juvenile sarcoidosis.
abstract: BACKGROUND
  Juvenile sarcoidosis is a rare, chronic, multisystem, granulomatous disease of obscure etiology which is seen in childhood and adulthood. The disease in childhood has a course different from that in adulthood.
  
  
  METHODS
  PubMed database was searched using terms sarcoidosis, children or childhood sarcoidosis or juvenile sarcoidosis in combination with one of the following terms: epidemiology, clinical manifestations, genetics, diagnosis, treatment, and prognosis. We also retrieved the terms such as early onset sarcoidosis and Blau syndrome. Furthermore, e-medicine and European Respiratory Society monographs for sarcoidosis were reviewed.
  
  
  RESULTS
  Sarcoidosis in childhood presents with two age dependent, distinct forms. In younger children it is clinically evident before the age of four years and characterized by the triad of rash, arthritis and uveitis. In their older counterparts, the juvenile late onset sarcoidosis involves several organs and its clinical appearance resembles the adult type of the disease, with the respiratory system being most frequently affected (hilar lymphadenopathy, pulmonary infiltrations). Steroid is the main agent of treatment whereas methotrexate is also used for beneficial steroid sparing effects. New, novel therapies may change the outcome of the disease especially in difficult morbid cases.
  
  
  CONCLUSIONS
  Sarcoidosis in childhood is recognized as a systemic disease affecting various organs and having diverse clinical course depending on the age of onset.
authors.affiliation: Third Department of Pediatrics, University of Athens, School of Medicine "Attikon" University Hospital, Athens, Greece.
authors.forename: Andrew
authors.initials: A
authors.lastname: Fretzayas
authors.forename: Maria
authors.initials: M
authors.lastname: Moustaki
authors.forename: Olga
authors.initials: O
authors.lastname: Vougiouka
mesh_terms: D001168:Arthritis; D003389:Cranial Nerve Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D049268:Positron-Emission Tomography; D011379:Prognosis; D012507:Sarcoidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D013585:Synovitis / Q000175:diagnosis*; D014605:Uveitis / Q000175:diagnosis*; D056660:Hereditary Autoinflammatory Diseases
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D008727:Methotrexate