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Sarcoidosis — RACP Paediatrics MCQ

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ModerateRespiratorySarcoidosisRACP Paediatrics

A 10-year-old presents with progressive dyspnoea, dry cough, and bilateral hilar lymphadenopathy on CXR. Serum ACE level is elevated. Biopsy shows non-caseating granulomas. What is the most likely diagnosis?

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Correct answer: B — Sarcoidosis

Progressive dyspnoea with bilateral hilar lymphadenopathy, elevated serum ACE, and non-caseating granulomas on biopsy is characteristic of sarcoidosis. Paediatric sarcoidosis is uncommon but important to recognise. In young children (<5 years), it may present as Blau syndrome with uveitis, arthritis, and skin rash rather than pulmonary disease.

Reference: RACP Paediatric Curriculum – Respiratory; RCH Melbourne – 2023