- Poster presentation
- Open Access
A rare case of sarcoid osteitis in a child with response to methotrexate
© Goel et al; licensee BioMed Central Ltd. 2008
- Published: 15 September 2008
- Lymph Node Biopsy
- Cervical Lymph Node
- Bone Involvement
Sarcoidosis is a disease of unknown origin characterised by noncaseating granuloma and can involve any tissue or organ. Osseous involvement in sarcoidosis is rare in children and long tubular bone involvement is even rarer. We present a case histologically proven as sarcoid osteitis of radius and humerus that had a dramatic response to methotrexate.
After 3 years of drug-induced remission, methotrexate was stopped. Eight months after stopping methotrexate he presented with painful swelling of left arm and forearm. Radiograph showed circumferential lesion with periosteal reaction and MRI scan confirmed surrounding oedema suggestive of acute lesion. Sarcoid osteitis was confirmed on biopsy by the presence of characteristic non caseating granuloma with giant cells. He was restarted on methotrexate upon which the lesions resolved in a few weeks.
Authors conclude that long bone involvement in a child with sarcoidosis is rare but we should have low threshold for biopsy in known case of sarcoidosis presenting with radiological feature of osteitis to confirm the diagnosis and for treatment. In our case there was excellent response to methotrexate.