Necrotizing sarcoid granulomatosis in a 14-yr-old female

A case of a 14-yr-old female with necrotizing sarcoid granulomatosis (NSG) is presented. She was referred because of chest pain and malaise, and radio graphy revealed multiple pulmonary nodules. Her history showed seasonal sen sitization to aeroallergens and hay fever. Infectious agents or malignancie s did not characterize these nodules, However, she was treated with macroli de antibiotics because of suspected infection with Chlamydia pneumoniae. Op en lung biopsy showed histological findings of NSG, with epithelioid granul omatous inflammation, including giant cells, acid vasculitis, No further tr eatment was performed, and symptoms disappeared within a few weeks. The che st radiograph showed gradual improvement. The aetiology of NSG is poorly understood, and is postulated to represent e ither sarcoidosis or rare forms of pulmonary vasculitis such as Wegener's g ranulomatosis or the Churg-Strauss syndrome. In the case presented, a coinc idence of infection with Chlamydia pneumoniae suggests an involvement of in fectious agents in the pattern of formation of immune complexes in the aeti ology of NSG.