🫁 Sarcoidosis · Granulomatous Lung Disease

Nelson Textbook of Pediatrics 22nd Edition | Idiopathic multisystem granulomatous disease. Young children (<4 years): triad of rash (erythema nodosum), uveitis, arthritis. Older children/adolescents: bilateral hilar lymphadenopathy (BHL), pulmonary infiltrates, erythema nodosum, polyarthralgias (Lofgren syndrome). Diagnosis: noncaseating granulomas on biopsy, BAL lymphocytosis with CD4:CD8 ratio >4, elevated serum ACE. Treatment: corticosteroids for progressive pulmonary disease, ocular disease, hypercalcemia, cardiac/CNS involvement. Heerfordt syndrome: uveitis, parotid enlargement, facial palsy, fever.

🌐 paeds.online — Pakistan's Pediatric Platform

📋 30 Clinical Scenarios — Sarcoidosis

📇 High‑Yield Cards: Sarcoidosis (Chap 448.3)

🩺 Interactive Clinical Approach: Suspected Sarcoidosis

Select a presentation for diagnostic and management approach.

📋 Stepwise Management of Sarcoidosis

    Organ SystemIndication for TreatmentTreatment
    PulmonaryProgressive dyspnea, declining PFTs (FVC), radiographic worseningPrednisone 1 mg/kg/day, taper after 4-8 weeks
    OcularUveitis (anterior, posterior), vision lossTopical steroids (anterior), systemic steroids (posterior), methotrexate
    HypercalcemiaCalcium >10.5 mg/dL, symptomaticCorticosteroids, low-calcium diet, hydration
    CardiacArrhythmias, heart block, cardiomyopathyCorticosteroids, implantable defibrillator

    ⚡ Reflex Prompts — Sarcoidosis Recognition & Management

    📖 Summary: Sarcoidosis — Nelson 22nd Ed

    Source: Nelson Textbook of Pediatrics 22nd Ed — Section 448.3. Sarcoidosis is a diagnosis of exclusion. BAL CD4/CD8 ratio >4 is highly suggestive. Lofgren syndrome has a good prognosis. Heerfordt syndrome is a rare presentation.