Vafa GULIYEVA, Fatma Gül DEMİRKAN, Ayşenur DOĞRU KILINÇ, Nihan AKSU CEYLAN, İlknur TUGAL TUTKUN, Nuray AKTAY AYAZ
Comprehensive Medicine - 2026;18(2):205-211
Objective: Sarcoidosis-associated uveitis is rare in children and can cause serious complications. Because pediatric data were limited, this study aimed to characterize clinical features, management, and outcomes using a multidisciplinary cohort approach. Materials and Methods: A retrospective analysis was conducted of patients under 18 years of age who were managed by the pediatric rheumatology and ophthalmology services between 2017 and 2024. Patients were classified as having probable sarcoidosis-associated uveitis according to the revised International Workshop on Ocular Sarcoidosis (IWOS) criteria because no biopsy was performed. Demographics, clinical characteristics, laboratory findings, treatments, and outcomes were analyzed. Results: Of the 24 patients screened, 15 (27 eyes) met the inclusion criteria. Age at inclusion was 14.73+/-2.87 years; age at diagnosis, 10.15 years (IQR, 8.28-11.23). The majority of patients presented with concurrent ocular and systemic sarcoidosis (73%), bilateral involvement (80%), and panuveitis (60%). Chronic inflammation occurred in 80% of patients. Pulmonary involvement was documented in 40% of cases All patients received topical corticosteroids; 86.7% required systemic corticosteroids. Methotrexate was the first-line conventional DMARD (93.3%), and adalimumab was the primary biologic agent (80%). Complete remission was achieved in 53.3% of cases, with surgery needed in 20% of cases. Ocular complications decreased from 33.3% at presentation to 20% at final follow-up. Neither age at onset nor pulmonary involvement significantly influenced remission status. Conclusion: Pediatric sarcoidosis-associated uveitis emphasizes the importance of a collaborative team-based approach. The absence of pulmonary involvement does not exclude the diagnosis, underscoring the need for a high index of clinical suspicion and comprehensive evaluation in children presenting with chronic uveitis.
