Neurosarcoidosis in Pediatric Patients: A Case Report and Review of Isolated and Systemic Neurosarcoidosis

• Published in: Pediatric neurology Vol. 63; pp. 45 - 52
• Main Authors: Rao, Rashmi, MD, Dimitriades, Victoria R., MD, Weimer, Maria, MD, Sandlin, Chelsey, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2016
• Subjects: Adolescent; Brain - diagnostic imaging; Brain - drug effects; Central Nervous System Diseases - diagnostic imaging; Central Nervous System Diseases - drug therapy; Humans; isolated neurosarcoid; Male; Neurology; neurosarcoidosis; pediatric neurosarcoidosis; pediatric sarcoid; Pediatrics; sarcoid; Sarcoidosis - diagnostic imaging; Sarcoidosis - drug therapy; Steroids - pharmacology; Steroids - therapeutic use; systemic neurosarcoidosis; neurosarcoidosis; pediatric sarcoid; systemic neurosarcoidosis; sarcoid; pediatric neurosarcoidosis; isolated neurosarcoid
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2016.05.018

Abstract Background Neurosarcoidosis occurs in fewer than 5% of adults with systemic sarcoid. However, only 53 examples of neurosarcoidosis have been reported in the pediatric population, with nine of those cases being isolated neurosarcoidosis. We present the tenth case of a child with an initial presentation of isolated neurosarcoidosis and a review of the literature. Methods We searched the Ovid Medline database from 1946 to May 28, 2015. The Mesh terms “neurosarcoidosis,” “pediatric,” and “child” were exploded, and the Boolean “AND” was used to combine “neurosarcoidosis” with “pediatric” or “child.” Articles that were not available in the English language were not included. Results A literature search revealed 53 children with neurosarcoidosis. The most common manifestations included cranial neuropathy (21%), papilledema or optic neuritis (15%), seizures (24.5%), and hypothalamic dysfunction (17%), with the latter two being more likely in younger children. Diagnosis is made by biopsy, but imaging and laboratory tests can aid in diagnosis. Treatment includes corticosteroids or other immunosuppressants. Conclusions Neurosarcoidosis in children is rare, and our patient is only the tenth child with isolated neurosarcoidosis. These patients highlight the importance of considering a noninfectious diagnosis in the setting of clinical and radiographic findings suggestive of neurosarcoidosis.