Prolonged fever, pancytopenia, and splenomegaly - is it sarcoidosis?

Abstract

Childhood Sarcoidosis is a chronic multisystem pinflammatory disease of unknown etiology. We report a case of a 9-year-old female who presented with nasal bleeding. She started with fever that persisted for 24 days associated with progressive splenomegaly, pancytopenia, and generalized lymphadenopathy. An extensive investigation was performed excluding infectious, neoplastic, autoimmune and immunodeficiency causes. Histological examination of a lymph node revealed multiple non-caseous granulomas, which together with the elevation of ACE and multiorgan involvement, suggested the diagnosis of sarcoidosis. She started oral prednisolone and after 4-month of follow-up there was a significant clinical and analytic improvement. This case represents a challenging diagnosis of an uncommon pediatric disease that should be considered in the differential diagnosis of a multisystemic disease with constitutional symptoms even in the absence of pulmonary involvement.

Sarcoidosis revealed by long-term fever at the Vierzon Hospital: About a case and literature review

“…The same is true for long-term fever, asthenia or weight loss [8]. Long-term fever was the mode of revelation of sarcoidosis in the studies by Matsuda et al [9], de Gonçalves et al [10], Thomas et al [11] and Kamath et al [12]. In the study Wang et al [13], longterm fever and weight loss were observed respectively in 22.5% and 16.25% of subjects followed for sarcoidosis.…”