Am Fam Physician. 1999 Sep 1;60(3):763-764.
to the editor: We read with great interest the excellent review article on sarcoidosis by Drs. Belfer and Stevens.1 The authors reviewed the epidemiology, clinical spectrum, diagnosis, treatment and prognosis of sarcoidosis. We would like to comment on vasculitis as another possible presentation of sarcoidosis.
Vasculitis associated with sarcoidosis is rare, but it has been reported in both adults2 and children.3 In adults, reported cases have included involvement of the abdominal aorta, pulmonary granulomatous angiitis, cutaneous vasculitis and granulomatous glomerulonephritis.2,4,5 A review of the literature reveals a wide spectrum of vasculitis in childhood sarcoidosis, including leukocytoclastic vasculitis, systemic vasculitis of small- to medium-sized vessels and large-vessel vasculitis.6
We suggest that all patients with sarcoidosis be followed carefully for the development of vessel wall disease.
1. Belfer MH, Stevens RW. Sarcoidosis: a primary care review. Am Fam Physician. 1998;58:2041–50.
2. Thompson JR. Vascular changes in sarcoidosis. Dis Chest. 1966;50:357–61.
3. Gross KR, Malleson PN, Culham G, Lirenman DS, McCormick AQ, Petty RE. Vasculopathy with renal artery stenosis in a child with sarcoidosis. J Pediatr. 1986;108(5 pt 1):724–6.
4. Maeda S, Murao S, Sugiyama T, Utaka I, Okamoto R. Generalized sarcoidosis with “sarcoid aortitis. Acta Pathol Jpn. 1983;33:183–8.
5. Muther RS, McCarron DA, Bennett WM. Renal manifestations of sarcoidosis. Arch Intern Med. 1981;141:643–5.
6. Shetty AK, Gedalia A. Sarcoidosis: a pediatric perspective. Clin Pediatr. 1998;37:707–17.
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