Paediatric Sarcoid - an Isolated Ocular Involvement, A Rare Case Report

Abstract

Childhood  ocular sarcoidosis is an uncommon disease and recognition of this disease in children  is often delayed because of lack of   awareness  and  familiarity with its clinical features. 13 year old female child presented with redness, pain, photophobia. On clinical evaluation granulomatous uveitis was diagnosed, followed which tuberculosis was ruled out by mantoux and   chest radiography. As Serum angiotensin converting enzyme level  was  grossly elevated, sarcoid was suspected for which she was started  on oral steroids. Four months later she turned up with      recurrent symptoms with pain on extraocular movements for which she was evaluated with MRI which showed bilateral lacrimal gland homogenous enchancement which was also suggestive of sarcoid with extraocular involvement. Hence she was started on steroids with methotrexate   for which she showed remission of symptoms. We describe this case study because usually children with sarcoid presents with clinical triad of   skin, joint and ocular involvement which is early onset type and late onset type children will have clinical picture similar to adults with predominant lung involvement, but our case presents with isolated ocular involvement.