Images in Neurology |

Uveitis and White Matter Abnormalities in Pediatric Sarcoidosis

Audra K. Miller, MD; Zarir Khademian, MD; Phillip L. Pearl, MD
Arch Neurol. 2010;67(7):890-891. doi:10.1001/archneurol.2010.127.
Text Size: A A A
Published online


A healthy 13-year-old white boy presented with vomiting, diarrhea, and fatigue after a 3-day youth group project in a rural setting. Workup revealed a hemoglobin concentration of 9.9 g/dL (to convert to grams per liter, multiply by 10), mean corpuscular volume of 77 L, C-reactive protein of 26 mg/L (to convert to nanomoles per liter, multiply by 9.524), and a erythrocyte sedimentation rate of 50 mm/hour. The anemia did not respond to iron therapy. Over the course of 6 weeks, the patient lost 5.4 kg, developed photophobia, and became uncharacteristically sullen, angry, and combative. Funduscopic examination and fluorescein angiography revealed uveitis, interpreted as highly consistent with sarcoidosis (Figure 1). His serum angiotensin-converting enzyme level was 113 U/L (reference range, 12-68 U/L; to convert to nanokatals per liter, multiply by 16.667). Magnetic resonance imaging of the brain showed prominent periventricular and subcortical white matter changes (Figure 2A). The patient was treated with prednisone and methotrexate and improved in 1 year. Follow-up after 1 year showed significant resolution of uveitis and cerebral white matter lesions (Figure 2B).

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

Funduscopic photograph showing dramatic uveitis at presentation.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Magnetic resonance imaging (fluid-attenuated inversion recovery sequence) showing bilateral, confluent, patchy hyperintensities in subcortical white matter (A), with improvement after a 1-year interval (B).

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics