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Pascal Kingah, Muhammad Alam, Karan Chugh, John Kamholz, Lobelia Samavati
BACKGROUND: Neurosarcoidosis is a serious extra pulmonary manifestation of sarcoidosis. Its presentation ranges from peripheral or cranial neuropathy to central nervous system dysfunction. It can mimic stroke or multiple sclerosis. Due to the variation in clinical presentation, diagnosis is difficult and often delayed. OBJECTIVE: Determine the proportion of patients with neurosarcoidosis who have positive findings on chest CT, lung biopsy or lymph node biopsy. METHODS: Retrospective study at the Sarcoidosis and Interstitial Lung Disease Center at Wayne State University-Detroit Medical Center in Detroit, MI...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Stephen J Balevic, Ankoor Shah
No abstract text is available yet for this article.
October 11, 2016: American Journal of Medicine
Ekin Akyildiz, Murat Yalcin, Fidan Sever, Hüseyin Semiz, Senol Kobak
Sarcoidosis is an inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, eye and musculoskeletal system involvement. Hypercalcemia and hypercalciuria are important electrolyte imbalances resulting from sarcoidosis and sometimes they may cause nephrolitiasis and kidney failure. Hyponatremia, although being quite rare, has been found in some patients with sarcoidosis. Herein, we have reported a patient with neurosarcoidosis who presented with hyponatremia and responded well to corticosteroid treatment...
October 5, 2016: Reumatología Clinica
Brandon Trivax, Alexandra Paraskos, Dena Abuelroos, Aishwarya Navalpakam
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Vedha Sanghi, Aanchal Kapoor
Hypernatremia is a frequent cause of intensive care unit admission. The patient presented in this article had hypernatremia refractory to D5W (dextrose 5% water) therapy, which led to a complex investigation. Workup revealed central diabetes insipidus most likely secondary to flare up of neurosarcoidosis. The challenge in terms of diagnosis was a presentation with low urine output in the setting of hypernatremia resistant to treatment with desmopressin. This case unfolded the role of hypothyroidism causing secondary renal dysfunction and hence needed continued treatment with thyroxine in addition to treatment for hypernatremia...
July 2016: Journal of Investigative Medicine High Impact Case Reports
W Reith, S Roumia, C Popp
CLINICAL/METHODICAL ISSUE: Neurosarcoidosis is a relatively rare complication of sarcoidosis that occurs in approximately 5-15 % of patients. The clinical picture is variable. Clinically, neurosarcoidosis is mostly manifested as lesions of the cranial nerves (50-70 %) and several cranial nerves are typically affected. This is the result of aseptic granulomatous basal meningitis. Intraparenchymal granulomas also occur, frequently affecting basal near-midline structures, such as the hypothalamus and pituitary glands and can lead to encephalopathy...
October 2016: Der Radiologe
Sonja E Leonhard, Daan Fritz, Diederik van de Beek, Matthijs C Brouwer
BACKGROUND: Cryptococcal meningitis is an uncommon but severe complication of sarcoidosis. METHODS: We present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature. RESULTS: When analyzing our patients and 38 cases reported in the literature, we found that median age of sarcoidosis patients with cryptococcal meningitis was 39 years (range 30-48); 27 of 33 reported cases (82%) had a history of sarcoidosis...
August 2016: Medicine (Baltimore)
Maxwell Elia, Ninani Kombo, John Huang
PURPOSE: To report a case of neurosarcoidosis with an isolated brain lesion mimicking a low-grade glioma. METHODS: A 38-year-old woman presented with 2 weeks of blurry vision in the left eye. Ophthalmic examination, visual field testing, fluorescein angiography, laboratory testing, and MRI of the brain were performed. RESULTS: Ophthalmic examination revealed left-sided optic nerve infiltration, and MRI of the brain demonstrated a solitary lesion in the brain...
August 26, 2016: Retinal Cases & Brief Reports
Rashmi Rao, Victoria R Dimitriades, Maria Weimer, Chelsey Sandlin
BACKGROUND: Neurosarcoidosis occurs in fewer than 5% of adults with systemic sarcoid. However, only 53 examples of neurosarcoidosis have been reported in the pediatric population, with nine of those cases being isolated neurosarcoidosis. We present the tenth case of a child with an initial presentation of isolated neurosarcoidosis and a review of the literature. METHODS: We searched the Ovid Medline database from 1946 to May 28, 2015. The Mesh terms "neurosarcoidosis," "pediatric," and "child" were exploded, and the Boolean "AND" was used to combine "neurosarcoidosis" with "pediatric" or "child...
October 2016: Pediatric Neurology
Iman Khodarahmi, Roger E Turbin, Larry P Frohman, Nasrin Ghesani
While the imaging modality of choice to diagnose neurosarcoidosis is gadolinium-enhanced MRI, F-FDG PET/CT maybe used to stage the disease or target the optimal biopsy site. Few cases have described intense F-FDG uptake at the sites of active neurosarcoidosis in the midbrain and pituitary gland, cerebellar hemispheres, and temporal lobes. Here, we present a case of neurosarcoidosis whose PET/CT examination demonstrated F-FDG avidity in a dural plaque.
September 2016: Clinical Nuclear Medicine
U Costabel, T E Wessendorf, F Bonella
Sarcoidosis is a systemic disease of unknown aetiology. Typical histology shows epithelioid cell granulomas, and typical immunopathology enhanced Th1 type immune responses in the involved organs. The disease occurs worldwide, but more frequently in northern countries than in the south. In Germany, the incidence is estimated to be 10 per 100,000, and the prevalence 44-48 per 100,000. Sarcoidosis usually affects adults under 50 years of age, but can also be seen in children, adolescents and in the elderly. Women are more frequently affected than men...
July 25, 2016: Klinische Monatsblätter Für Augenheilkunde
Veronika Kana, Jens A Petersen, Kristian Ikenberg, Ariane Chappaz, Christina Gerth-Kahlert, Philippe Appenzeller, Michael Linnebank
No abstract text is available yet for this article.
July 19, 2016: Neurology
Lewis D Hahn, Robert Fulbright, Joachim M Baehring
Hypertrophic Pachymeningitis (HP) denotes inflammation and thickening of the dura mater that can be idiopathic or secondary to a wide variety of conditions. Clinically, HP can present as debilitating headaches and cranial nerve defects but in other cases may be completely asymptomatic. We aimed to determine the relative incidence of different etiologies of HP and compare their associated imaging findings. Additionally, we sought to compare the clinical features of the underlying syndromes. We retrospectively examined twenty-two consecutive cases of HP seen in a single practitioner neurology practice over a ten-year time period...
August 15, 2016: Journal of the Neurological Sciences
Juergen Hench, Nicole Roschanski, Ekkehard Hewer, Uwe Rösler, Cornelia Lass-Flörl, Christoph Stippich, Markus Tolnay, Norman Rusche, Beat Sonderegger, Martin Sailer, Philippe Lyrer, Nils Peters, Stephan Frank
We report two cases of unclear granulomatous encephalitis where pathogenic algae, genus Prototheca, were identified as causative agent. Granulomatous encephalitis is - after exclusion of cause - per definition diagnosed and managed as neurosarcoidosis. However, protothecal infections go undetected by standard bacterial and fungal rDNA screening. As cerebral protothecosis is potentially treatable, raising awareness for this condition is relevant, because therapeutic immunosuppression is to be avoided. This article is protected by copyright...
June 23, 2016: Histopathology
Pooja Prathapan Sarada, Krishnaswamy Sundararajan
Guillain-Barré syndrome (GBS) is an acute demyelinating polyneuropathy, usually evoked by antecedent infection. Sarcoidosis is a multisystem chronic granulomatous disorder with neurological involvement occurring in a minority. We present a case of a 43-year-old Caucasian man who presented with acute ascending polyradiculoneuropathy with a recent diagnosis of pulmonary sarcoidosis. The absence of acute flaccid paralysis excluded a clinical diagnosis of GBS in the first instance. Subsequently, a rapid onset of proximal weakness with multi-organ failure led to the diagnosis of GBS, which necessitated intravenous immunoglobulin and plasmapheresis to which the patient responded adequately, and he was subsequently discharged home...
April 2016: Indian Journal of Critical Care Medicine
Jacob B Hunter, Alejandro Rivas
There have been recent reports of sarcoid-like granulomatosis development following the administration of tumor necrosis factor (TNF) inhibitors. To date, only four cases of neurosarcoidosis have been reported in association with TNF inhibitors, two of which were attributed to etanercept. We present the first case of etanercept-induced neurosarcoidosis involving multiple cranial neuropathies, including the trigeminal, facial, and vestibulocochlear nerves, while also highlighting the differential diagnoses of multiple cranial neuropathies and the association of TNF inhibitors and neurosarcoidosis...
May 2016: American Journal of Otolaryngology
Kiyoharu Shimizu, Kiyoshi Yuki, Takashi Sadatomo, Kaoru Kurisu
BACKGROUND: As an extremely rare subtype of sarcoidosis that develops exclusively in the nervous system, isolated neurosarcoidosis is difficult to diagnose. In addition, its exact clinical features are not known. CASE DESCRIPTION: A 61-year-old man presented with right ear hearing loss, diplopia, and fever. Computed tomography (CT) and magnetic resonance imaging revealed mass lesions in the right cerebellum and left side body of the lateral ventricle. Neither systemic CT nor positron emission tomography revealed extracranial lesions...
2016: Surgical Neurology International
Maciej Horyniecki, Marta Konieczna, Magdalena Torbus, Krystyna Pierzchała, Maciej Wawrzyńczyk, Beata Łabuz-Roszak
Neurosarcoidosis (NS) manifests itself clinically in approximately 8-13% of patients with sarcoidosis. Granulomas are localized in both the central and peripheral nervous system, mainly within the meninges and cranial nerves. Changes may spread interstitially, occupying different structures of the brain and spinal cord. Diagnosis of NS is made by characteristic clinical symptoms and the exclusion of other diseases, with the presence of specific changes in the magnetic resonance and cerebrospinal fluid, and it is mainly based on histopathological examination...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Özgür Bilgin Topçuoğlu, Murat Kavas, Selahattin Öztaş, Sibel Arınç, Gülgün Afşar, Sema Saraç, İpek Midi
Sarcoidosis is a multisystem granulomatous disease affecting nervous system in 5% to 10% of patients. Magnetic resonance imaging (MRI) is accepted as the most sensitive method for detecting neurosarcoidosis. However, the most common findings in MRI are the nonspecific white matter lesions, which may be unrelated to sarcoidosis and can occur because of hypertension, diabetes mellitus, smoking, and other inflammatory or infectious disorders, as well. Autopsy studies report more frequent neurological involvement than the ante mortem studies...
April 22, 2016: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
Philippe Joaquim Oliveira Menezes Macêdo, Victor Calil da Silveira, Luíza Tavares Ramos, Felipe Resende Nóbrega, Luiz Felipe Rocha Vasconcellos
A 62-year-old male presented to our clinic with recurrent fever, skin lesions (petechiae), scleral wounds, and hilar adenomegaly. A diagnosis of sarcoidosis was established, which resolved with corticosteroid treatment. After a few months, the patient developed confusion and behavioral changes, with few objective neurological deficits. Brain magnetic resonance imaging showed slight focal meningeal enhancement (prepontine region). The level of angiotensin-converting enzymes was normal in the serum and increased in the cerebrospinal fluid...
June 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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