title: [Hypercalcemia revealing sarcoidosis in a child].
abstract: Sarcoidosis is a systemic granulomatosis disease with a classic triad of presentation: typical clinical and radiological signs, presence of tuberculoid granuloma without caseum in histopathology, and exclusion of other causes of granulomatosis, especially tuberculosis. Sarcoidosis is rare in the general population, and even more so in children. In the literature, few cases of sarcoidosis associated with hypercalcemia have been reported in children. We report here the case of a 14-year-old boy with bone marrow and lymph node sarcoidosis suspected, based on poor general condition with hypercalcemia. The patient was treated with hydration, diuretics, and bisphosphonates with good results. We also performed a literature review of published cases of hypercalcemia since 1990 with a diagnosis of sarcoidosis in children, comparing 23 cases (including ours) on clinical and epidemiological, biological, imaging, and histopathological diagnosis. When hypercalcemia is present in the initial clinical presentation, the diagnosis of sarcoidosis is usually made in younger children. Classical locations of the lesions, including lung, skin, and lymph nodes, were highly suggestive of sarcoidosis. Corticosteroids are commonly used to treat sarcoidosis lesions including hypercalcemia. In conclusion, sarcoidosis in children remains difficult to diagnose because the disease is rare and it is common to have nonspecific symptoms in the clinical picture (with diagnosis delayed between 3 months and several years). The classic triad is not always present. Sarcoidosis should be systematically considered and investigated in case of hypercalcemia of unknown cause in children.
authors.affiliation: Service de pédiatrie, hôpital Carémeau, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Kinné
authors.affiliation: Service de pédiatrie, hôpital Carémeau, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France; Inserm U 1183, équipe 3, groupe nîmois : immuno-régulation et microbiote, faculté de médecine de Montpellier-Nîmes, 186, chemin du Carreau-de-Lanes, CS 83021, 30908 Nîmes cedex 2, France. Electronic address: anne.filleron@chu-nimes.fr.
authors.forename: A
authors.initials: A
authors.lastname: Filleron
authors.affiliation: Service de pédiatrie, hôpital Carémeau, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Salet
authors.affiliation: Service d'oncohématologie pédiatrique, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
authors.forename: L
authors.initials: L
authors.lastname: Saumet
authors.affiliation: Service de pédiatrie, hôpital Carémeau, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Baron Joly
authors.affiliation: Service de pédiatrie, hôpital Carémeau, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France; Inserm U 1183, équipe 3, groupe nîmois : immuno-régulation et microbiote, faculté de médecine de Montpellier-Nîmes, 186, chemin du Carreau-de-Lanes, CS 83021, 30908 Nîmes cedex 2, France.
authors.forename: T A
authors.initials: TA
authors.lastname: Tran
mesh_terms: D000293:Adolescent; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004164:Diphosphonates / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D004232:Diuretics; D005938:Glucocorticoids