A 3-year-old girl was referred by her paediatric rheumatologist for screening for uveitis due to a diagnosis of suspected juvenile idiopathic arthritis. She suffered from attacks of fever, polyarthritis and a maculopapular skin rash, which also suggested a diagnosis of sarcoidosis. However, at that time the synovial biopsy showed a negative result for granulomatous inflammation. There were no ophthalmological complaints. She had full visual acuity in both eyes. On slit-lamp examination, multiple subepithelial corneal nebulae and focal active keratitis were observed as well as bilateral anterior uveitis (fig 1A). At the lumbus, there were small yellow conjunctival nodules suspected of being granulomas. Funduscopy revealed no abnormalities of the posterior segment. She underwent various laboratory-examinations including full blood counts, antinuclear antibodies (ANA) and angiotensin-converting enzyme (ACE), assessment for tuberculosis and radiological chest examinations, the results of which were all within normal limits. The keratitis and anterior uveitis responded to treatment with topical corticosteroids. In the mean time, she was treated for her arthritis with methotrexate and later on with etanercept.
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