title: [Misdiagnosed childhood sarcoidosis as non-Langerhans' cell histiocytosis treated with tumor necrosis factors-α antagonists].
abstract: Sarcoidosis is a chronic multisystemic granulomatous disease of unknown origin. Generalised eruptive histiocytosis is a rare, benign, self-healing, non-Langerhans' cell histiocytosis (non-LCH). We report the case of an 8-year-old girl with sarcoidosis who was misdiagnosed as non-LCH. She was treated with oral corticosteroids, methotrexate and adalimumab, but there was insufficient control of ocular disease. The introduction of infliximab achieved a control of the uveitis and enabled the corticosteroid dose to be tapered. In some cases of sarcoidosis the lack of well-organised granuloma formation at the beginning of the disease, and the presence of prominent giant cells may suggest alternative diagnoses, such as non-LCH. Although the experience of tumour necrosis factor-α antagonists use in children with sarcoidosis is limited, these drugs may be helpful for those patients experiencing a severe and refractory disease.
authors.affiliation: Servicio de Dermatología y Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España. gisepetiti@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Petiti Martin
authors.forename: M
authors.initials: M
authors.lastname: Castellanos González
authors.forename: J
authors.initials: J
authors.lastname: Sanz Bueno
authors.forename: M
authors.initials: M
authors.lastname: Burgués Calderón
authors.forename: M
authors.initials: M
authors.lastname: Villar Buil
authors.forename: F
authors.initials: F
authors.lastname: Vanaclocha
authors.forename: J L
authors.initials: JL
authors.lastname: Peralto
mesh_terms: D000068879:Adalimumab; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D002648:Child; D003951:Diagnostic Errors; D005260:Female; D015616:Histiocytosis, Non-Langerhans-Cell / Q000175:diagnosis*; D006801:Humans; D000069285:Infliximab; D008727:Methotrexate / Q000627:therapeutic use; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014605:Uveitis / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D008727:Methotrexate