Abstrakt

A 17-year-old formerly healthy male teenager presented to our hospital with a history of headache, weight loss around 10 kg and general discomfort. With spiking temperatures and nausea he first presented to another hospital, where a gastroscopy showed unspecific hypersecretory gastritis; a chest X-ray was found normal. He had high inflammatory markers, while repeated blood cultures showed no bacteremia. He was first treated with iv antibiotics and discharged after 2 weeks. Two weeks later he again presented with spiking temperatures, nausea and high inflammatory markers, and a herpes zoster. Calprotectin was slightly elevated, LFT and immune workup, ACE, CSF and bone marrow aspirate and a coloscopy were normal and inconclusive. He received aciclovir. Spirometry showed a reduced vital capacity of 67% predicted, and a second chest X-ray now showed peripheral bilateral infiltrates. A chest CT then showed normal lymph nodes, and in the lung parenchyma centrilobular nodular lesions with the „treein- bud“phenomenon. In an open lung biopsy the diagnosis of sarcoidosis could be established; soluble IL2 receptor was elevated (2.695 U/l). Diagnosis and differential diagnostic considerations in sarcoidosis are discussed further. Our patient became well and remained symptom-free after steroid treatment only for about one year so far.

Autoreninformation

Autoren

• P. Kaiser¹
• M. Clausmeyer²
• W. Wiebicke¹

Abteilungen

• ¹ Prof.-Hess-Kinderklinik und
• ² Institut für Pathologie, Klinikum Bremen-Mitte

Adresse

Dr. med. P. Kaiser
Prof.-Hess-Kinderklinik
Klinikum Bremen-Mitte
St. Jürgen-Straße
D-28205 Bremen
Email: [email protected]

Citation