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Necrotizing Sarcoid Granulomatosis in a 15-Year-Old Male

Mazin Alhamdani, Abhinav Parikh, Pramod Narula, Rabia Mir

(Department of Pediatrics, New York Methodist Hpspital, Brooklyn, NY, USA)

Med Sci Case Rep 2015; 2:38-43

DOI: 10.12659/MSCR.895271


BACKGROUND: Necrotizing sarcoid granulomatosis is a rare disease in adults but it is even rarer in the pediatric population. With only a few case reports available in the literature, physicians still do not have clear cut guidelines on how to approach a child with this disease entity. There is an ongoing debate as to whether necrotizing sarcoid granulomatosis is a variant of sarcoidosis or a separate disease. Necrotizing sarcoid granulomatosis is mainly diagnosed based on radiological findings of pulmonary nodular infiltrates and characteristic pathological changes, such as non-caseating epithelioid cell granulomas, granulomatous vasculitis, and necrosis.
CASE REPORT: We present the case of a 15-year-old African-American male who developed abdominal pain, weight loss, fever, cough, and night sweats over the course of 7 weeks. The patient was ultimately diagnosed with necrotizing sarcoid granulomatosis based on the pathology findings in a thoracoscopically-obtained pleural biopsy. He improved after initiating treatment with oral prednisolone.
CONCLUSIONS: Through this case report, we hope to add insight regarding necrotizing sarcoid granulomatosis in the pediatric population and to encourage physicians to consider necrotizing sarcoid granulomatosis (whether considered a variant of sarcoidosis or a separate disease entity) as a possible differential diagnosis in similar clinical presentations once infectious and autoimmune etiologies have been ruled out.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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