{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T18:17:13Z","timestamp":1788891433475,"version":"build-2803163510"},"reference-count":51,"publisher":"The Journal of Rheumatology","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the phenotype, disease course, and treatment of a large cohort of children with sarcoidosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with biopsies consistent with sarcoidosis, performed between 2010 and 2020, were included in this study. Patients\u2019 notes were reviewed retrospectively. Children with disease onset before 5 years of age were compared with older children. Regression analysis was performed to determine predictors of treatment outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 48 children with a mean age at diagnosis of 9.5 years, with a male to female ratio of 0.71, were identified. In total, 72% of the children were of Black race and 94% had multiorgan disease, with an average of 4.8 organs involved, most commonly lymph nodes (65%), skin (63%), and eyes (60%). Laboratory findings of note included raised serum calcium in 23% of patients and raised angiotensin-converting enzyme in 76% of patients. Out of 14 patients tested, 6 had mutations in<jats:italic>NOD2<\/jats:italic>. In total, 81% of patients received systemic steroids and 90% received conventional disease-modifying antirheumatic drugs (DMARDs); in 25% of patients, a biologic was added, mostly anti\u2013tumor necrosis factor (anti-TNF). Although most patients could be weaned off steroids (58%), most remained on long-term DMARDs (85%). Children under the age of 5 years presented more often with splenomegaly (<jats:italic>P<\/jats:italic>= 0.001), spleen involvement (<jats:italic>P<\/jats:italic>= 0.003), and higher C-reactive protein (<jats:italic>P<\/jats:italic>= 0.10). Weight loss was more common in adolescents (<jats:italic>P<\/jats:italic>= 0.006). Kidney (<jats:italic>P<\/jats:italic>= 0.004), eye (<jats:italic>P<\/jats:italic>= 0.005), and liver involvement (<jats:italic>P<\/jats:italic>= 0.03) were more common in Black patients. Regression analysis identified no single factor associated with positive treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Multiorgan involvement, response to steroids, and chronic course are hallmarks of pediatric sarcoidosis. The phenotype significantly varies by age and race. 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