Inhaled corticosteroids for maintenance treatment in childhood pulmonary sarcoidosis

We present our experience with sequential oral and inhaled corticosteroid t herapy in childhood pulmonary sarcoidosis. Fifteen children were followed-u p for a mean of 7 y. Treatment consisted of oral prednisolone 2 mg/kg/d on initial diagnosis. After remission was reached, alternate day therapy with I mg/kg was continued. The dose was tapered to a maintenance dose which con trolled the activity of the disease. When patients were free of symptoms an d had no clinical and laboratory findings, inhaled corticosteriod treatment was started. Relapse treatment consisted of cessation of inhaled corticost eroids and start of oral corticosteroids at a dosage of 2 mg/kg/d and then a tapered dose. Five patients were given oral corticosteroids only. Nine pa tients were given inhaled steroids after oral corticosteroid therapy had be en discontinued. Clinical and radiological remissions were achieved in ever y patient. Conclusion: Sequential oral and inhaled corticosteroid therapy may be an al ternative treatment regimen for sarcoidosis in children.