Sarcoidosis Presenting With Nephritis and Pancreatitis in a Pediatric Patient: A Rare Case

Sarcoidosis is a multisystem granulomatous disorder of undetermined etiology that usually affects the lungs. It is a rare presentation to have an association between sarcoidosis and pancreatitis. We present a challenging case of acute pancreatitis and kidney dysfunction which had been diagnosed later to be sarcoidosis. A 12-year-old boy with abdominal pain and weight loss for one month, however, had no respiratory manifestations. Investigations revealed elevated lipase and creatinine. The patient was managed for acute kidney injury with an initial suspicion for autoimmune pancreatitis. Further workup revealed acute interstitial nephritis with non-necrotizing granuloma on renal biopsy. He developed uveitis and was found to have a variant in the angiotensin-converting enzyme (ACE) gene, which led to the diagnosis of sarcoidosis. According to our knowledge, this is the first case with juvenile sarcoidosis involving the pancreas and kidney.