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Pediatric Sarcoidosis: A Review with Emphasis on Early Onset and High-Risk Sarcoidosis and Diagnostic Challenges

1
Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
2
Section of Neuropathology, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
3
Department of Paediatrics, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
*
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(4), 160; https://doi.org/10.3390/diagnostics9040160
Received: 15 August 2019 / Revised: 18 October 2019 / Accepted: 21 October 2019 / Published: 25 October 2019
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)
Sarcoidosis is a non-necrotizing granulomatous inflammatory syndrome with multisystemic manifestations. We performed a systematic review of sarcoidosis in the pediatric population with particular emphases on early onset sarcoidosis, high-risk sarcoidosis, and newly reported or unusual sarcoid-related diseases. Blau Syndrome and early onset sarcoidosis/ BS-EOS are seen in children younger than five years old presenting with extra-thoracic manifestations but usually without lymphadenopathy and/or pulmonary involvement. The prevalence of high-risk sarcoidosis is very low in children and is further limited by the difficulty of diagnosis in symptomatic children and underdiagnosis in subclinical or asymptomatic patients. Reports of sarcoidal syndromes in users of E-cigarette/marijuana/other flavorings and their induction in cancer immunotherapies are of interests and may be challenging to differentiate from metastatic malignancy. The diagnostic considerations in pediatric sarcoidosis are to support a compatible clinicoradiographic presentation and the pathologic findings of non-necrotizing granulomas by ruling out granulomas of infective etiology. There is no absolutely reliable diagnostic test for sarcoidosis at present. The use of endoscopic bronchial ultrasound (EBUS) and transbronchial fine needle aspiration (TBNA) sampling of intrathoracic lymph nodes and lung, and for superficially accessible lesions, with cytopathological assessment and pathological confirmations provide fair diagnostic yield and excellent patient safety profile in children. View Full-Text
Keywords: Paediatric sarcoidosis; high-risk sarcoidosis; early-onset sarcoidosis; diagnostics; Blau syndrome Paediatric sarcoidosis; high-risk sarcoidosis; early-onset sarcoidosis; diagnostics; Blau syndrome
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Chiu, B.; Chan, J.; Das, S.; Alshamma, Z.; Sergi, C. Pediatric Sarcoidosis: A Review with Emphasis on Early Onset and High-Risk Sarcoidosis and Diagnostic Challenges. Diagnostics 2019, 9, 160.

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