keyword
https://read.qxmd.com/read/38490454/clinical-challenge-looking-beyond-blurred-margins
#1
JOURNAL ARTICLE
Jimmy S Chen, Bobby S Korn, Andrew R Carey, Peter J Savino
A 60-year-old man presented to an outside ophthalmology clinic with 1 month of progressive vision loss in the right eye (OD). Right optic disc edema was noted. Brain and orbit magnetic resonance imaging revealed right optic nerve and left occipital lobe enhancement. He was seen initially by neurology and neurosurgery and subsequently referred to neuro-ophthalmology for consideration of optic nerve biopsy. He was seen 3 months after his initial symptom onset where vision was light perception OD and a relative afferent pupillary defect with optic nerve edema...
March 13, 2024: Survey of Ophthalmology
https://read.qxmd.com/read/38111471/recurrent-multiple-eye-muscle-palsy-as-a-first-sign-of-sarcoidosis
#2
Isabel Deboutte, Daisy Godts, Michel Van Lint
PURPOSE: To report a case of (neuro)sarcoidosis presenting solely with recurrent cranial nerve palsies in a 57-year-old Caucasian female. METHODS: Case report with clinical imaging. RESULTS: A 57-year-old female first presented with a right sixth nerve palsy, which resolved spontaneously after 6 months. Three years later she was diagnosed with a sixth nerve palsy in the fellow eye followed by a complete palsy of the left third cranial nerve four months after...
2023: GMS Ophthalmology Cases
https://read.qxmd.com/read/38031193/typical-trident-sign-and-cardiac-involvement-in-a-patient-suspected-to-sarcoidosis-despite-negative-whole-body-fdg-pet-a-case-report
#3
JOURNAL ARTICLE
Abootorab Shahmohammdi, Hora Heidari, Kosar Kohandel, Soheil Dousti, Rozita Doosti, Amir Reza Azimi, Zahra Shajari, Parham Rabiei, Sareh Shahmohammdi
BACKGROUND: Sarcoidosis is a systemic inflammatory disease histologically defined by the non-caseation granulomas formation in different organs, most commonly lungs, liver, skin, gastrointestinal system, eyes, neurologic and cardiac system CASE PRESENTATION: We report the case of a 42-year-old Gilaks woman who presented with myelopathy with characteristic MRI finding called trident sign. By finding this view in axial spinal Magnetic Resonance Imaging (MRI) imaging, a systemic evaluation was performed on the patient, which led to the diagnosis of cardiac involvement in Sarcoidosis with the specific appearance of this disease in cardiac MRI despite the negative Fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan...
November 30, 2023: Journal of Medical Case Reports
https://read.qxmd.com/read/37991878/big-data-analysis-of-inflammatory-conditions-associated-with-optic-neuritis
#4
JOURNAL ARTICLE
James B Davis, Amanda D Henderson, Andrew R Carey
BACKGROUND: Previous studies in the United States established multiple sclerosis (MS) as the most common cause of optic neuritis (ON). ON can be associated with other systemic inflammatory conditions including sarcoidosis, neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and lupus; however, prospective studies to establish risk of ON associated with these diseases are lacking. Furthermore, appropriate workup for ON is still debated...
November 22, 2023: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://read.qxmd.com/read/37958968/beyond-myelin-oligodendrocyte-glycoprotein-and-aquaporin-4-antibodies-alternative-causes-of-optic-neuritis
#5
REVIEW
Giacomo Greco, Elena Colombo, Matteo Gastaldi, Lara Ahmad, Eleonora Tavazzi, Roberto Bergamaschi, Eleonora Rigoni
Optic neuritis (ON) is the most common cause of vision loss in young adults. It manifests as acute or subacute vision loss, often accompanied by retrobulbar discomfort or pain during eye movements. Typical ON is associated with Multiple Sclerosis (MS) and is generally mild and steroid-responsive. Atypical forms are characterized by unusual features, such as prominent optic disc edema, poor treatment response, and bilateral involvement, and they are often associated with autoantibodies against aquaporin-4 (AQP4) or Myelin Oligodendrocyte Glycoprotein (MOG)...
November 5, 2023: International Journal of Molecular Sciences
https://read.qxmd.com/read/37841263/interleukin-6-at-the-interface-of-human-health-and-disease
#6
REVIEW
Elena Grebenciucova, Stephen VanHaerents
Interleukin 6 (IL-6) is a pleiotropic cytokine executing a diverse number of functions, ranging from its effects on acute phase reactant pathways, B and T lymphocytes, blood brain barrier permeability, synovial inflammation, hematopoiesis, and embryonic development. This cytokine empowers the transition between innate and adaptive immune responses and helps recruit macrophages and lymphocytes to the sites of injury or infection. Given that IL-6 is involved both in the immune homeostasis and pathogenesis of several autoimmune diseases, research into therapeutic modulation of IL-6 axis resulted in the approval of a number of effective treatments for several autoimmune disorders like neuromyelitis optica spectrum disorder (NMOSD), rheumatoid arthritis, juvenile idiopathic arthritis, polyarticular juvenile idiopathic arthritis, giant cell arteritis (GCA), and cytokine release syndrome, associated with SARS-CoV2 pneumonia...
2023: Frontiers in Immunology
https://read.qxmd.com/read/37814569/granulomatous-peritoneal-disease-associated-with-oxaliplatin-based-chemotherapy-for-ampullary-adenocarcinoma-a-case-report
#7
G Vermeersch, N Cruyt, E D'Hondt, J Geers, K Hertveldt, A Stockman, G Lambrecht
Adenocarcinomas of the ampulla of Vater represent only 0.2% of all gastrointestinal cancers. Due to the low incidence no large clinical trials evaluating efficacy of treatments are available. Adjuvant therapy is often administered in patients with stage IB or higher. Oxaliplatin is considered as an effective and well tolerated therapeutic option. Adverse events associated with this therapy include cardio-, neuro-, nephrotoxicity and myelosuppression. Previously granulomatous pulmonary and liver manifestations have been described in oxaliplatin-based chemotherapy...
2023: Acta Gastro-enterologica Belgica
https://read.qxmd.com/read/37692752/neurosarcoidosis-with-multi-organ-involvement-a-case-report-and-literature-review
#8
Nicolas Naccarella, Samia Ikhlef, Jacques Rommens
Sarcoidosis is a multisystemic disease that, in rare cases, can involve the central nervous system (CNS). We present a case of sarcoidosis with intracranial and multi-organ involvement. The patient presented with a one-month history of headaches. Imaging revealed leptomeningeal nodular enhancement (LNE), and a PET/CT scan of the chest and abdomen showed bilateral hilar, retroperitoneal, and inguinal lymphadenopathy. The diagnosis of sarcoidosis was confirmed by an ultrasound-guided inguinal lymph node biopsy...
August 2023: Curēus
https://read.qxmd.com/read/37568942/sudden-vision-loss-due-to-optic-neuritis-an-uncommon-presentation-of-neurosarcoidosis
#9
Katarzyna Zimna, Monika Szturmowicz, Małgorzata Sobiecka, Katarzyna Błasińska, Małgorzata Bartosiewicz, Witold Z Tomkowski
Sarcoidosis is a systemic, granulomatous disease of unknown etiology, most often manifested by mediastinal and hilar lymph node enlargement and parenchymal nodules in the lungs. However, it may involve any other organ. Neuro-sarcoidosis, a condition that affects up to 20% of sarcoidosis patients, can be found in any part of the central or peripheral nervous system and has important ophthalmic and neuro-ophthalmic manifestations. We present two patients with sudden vision loss due to neurosarcoidosis. In both cases, biopsy of the mediastinal lymph node showed non-caseating granulomas consistent with sarcoidosis...
August 3, 2023: Diagnostics
https://read.qxmd.com/read/37535461/dural-and-leptomeningeal-diseases-anatomy-causes-and-neuroimaging-findings
#10
JOURNAL ARTICLE
Ryo Kurokawa, Mariko Kurokawa, Saiko Isshiki, Taisuke Harada, Moto Nakaya, Akira Baba, Shotaro Naganawa, John Kim, Jayapalli Bapuraj, Ashok Srinivasan, Osamu Abe, Toshio Moritani
Meningeal lesions can be caused by various conditions and pose diagnostic challenges. The authors review the anatomy of the meninges in the brain and spinal cord to provide a better understanding of the localization and extension of these diseases and summarize the clinical and imaging features of various conditions that cause dural and/or leptomeningeal enhancing lesions. These conditions include infectious meningitis (bacterial, tuberculous, viral, and fungal), autoimmune diseases (vasculitis, connective tissue diseases, autoimmune meningoencephalitis, Vogt-Koyanagi-Harada disease, neuro-Behçet syndrome, Susac syndrome, and sarcoidosis), primary and secondary tumors (meningioma, diffuse leptomeningeal glioneuronal tumor, melanocytic tumors, and lymphoma), tumorlike diseases (histiocytosis and immunoglobulin G4-related diseases), medication-induced diseases (immune-related adverse effects and posterior reversible encephalopathy syndrome), and other conditions (spontaneous intracranial hypotension, amyloidosis, and moyamoya disease)...
August 2023: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://read.qxmd.com/read/37361664/neurosarcoidosis-in-an-adult-man-with-a-family-history-of-ms-a-case-report
#11
Omid Mirmosayyeb, Mahtab Mohammadzamani, Sara Bagherieh, Elham Moases Ghaffary, Elham Sadat Azimi, Aysa Shaygannejad, Vahid Shaygannejad
KEY CLINICAL MESSAGE: According to this report, a biopsy revealed a diagnosis of neurosarcoidosis in a patient with a history of MS. The development of the disease can be slowed down by early diagnosis and appropriate treatment. ABSTRACT: Neurosarcoidosis is a rare type of sarcoidosis that affects the central nervous system (CNS). Herein, we present a case of neurosarcoidosis with a history of multiple sclerosis (MS). Based on the pathological findings of the biopsy, a diagnosis of neurosarcoidosis was established...
June 2023: Clinical Case Reports
https://read.qxmd.com/read/36718604/a-review-of-rheumatoid-meningitis-with-case-studies
#12
JOURNAL ARTICLE
Merve Aktan Suzgun, Nursena Erener, Gokce Hande Cavus, Ayse Ozdede, Sabriye Guner, Serdal Ugurlu, Nil Comunoglu, Osman Kizilkilic, Sabahattin Saip
OBJECTIVES: Rheumatoid arthritis (RA) is an autoimmune disease involving synovial joints, and it is known that extra-articular manifestations that may affect the central and peripheral nervous systems may develop during its course. Rheumatoid meningitis is very rare among all neurological involvements. In this study, cases diagnosed as rheumatoid meningitis with clinical, imaging, laboratory, and histopathological features are presented, and the aim of the study is to present current approaches in the diagnosis and treatment of rheumatoid meningitis in the light of case studies and current literature...
January 31, 2023: Modern rheumatology case reports
https://read.qxmd.com/read/36352598/atypical-optic-neuritis-the-potential-red-flags
#13
JOURNAL ARTICLE
Pawan T Ojha, Prachi P Barvalia, Rakesh Singh, Girish Soni, Nikhil Kadam, Shashank Nagendra, Vikram Aglave, Kamlesh Jagiasi
BACKGROUND: Many potential causes of optic nerve inflammation exist, including typical and atypical causes, which require different management strategies. OBJECTIVE: The objective of this study is to identify red flags that help differentiate typical from atypical optic neuritis (ON). MATERIALS AND METHODS: This prospective study included 66 patients (100 eyes) with immune-mediated ON from January 2016 to June 2019, carefully excluding the nonimmune causes...
2022: Neurology India
https://read.qxmd.com/read/36223603/isolated-optic-disc-granuloma-as-a-presenting-sign-of-sarcoidosis
#14
JOURNAL ARTICLE
Enny Oyeniran, David Katz, Shilpa Kodati
PURPOSE: To report a case of an optic disc granuloma secondary to sarcoidosis in the absence of any systemic symptoms nor evident signs of intraocular inflammation at the time of presentation. METHODS: Retrospective case report. RESULTS: A 59-year-old Caucasian woman with previously unrevealing systemic work up was referred to the uveitis service for persistent optic disc edema of the right eye for over 1 year. Fundoscopic examination revealed an optic disc granuloma with associated hyper-reflectivity on OCT and high surface reflectivity with medium internal reflectivity on B-scan ultrasound...
October 12, 2022: Ocular Immunology and Inflammation
https://read.qxmd.com/read/36164269/an-unusual-presentation-of-neurosarcoidosis
#15
JOURNAL ARTICLE
Erdal Sarac, Sergul A Erzurum, Ali Arif
BACKGROUND Sarcoidosis is a systemic granulomatous disease of unknown cause, often affecting the lungs and lymphatic system. Neurologic manifestations of sarcoidosis, called "neurosarcoidosis", can present as cranial neuropathies and occur in an isolated fashion or alongside other systemic findings. These findings occur in about 5% to 15% of individuals, and mainly in women between the ages of 30 and 40 years. Within those subsets of patients who develop neurologic manifestations, ocular manifestations occur 13% to 79% of the time...
September 27, 2022: American Journal of Case Reports
https://read.qxmd.com/read/35795795/case-report-drug-induced-neuro-sarcoidosis-like-lesion-under-il4-receptor-blockade-with-dupilumab
#16
Stergios Tsitos, Lisa Catherina Niederauer, Paula Albert I Gracenea, Johanna Mueller, Andreas Straube, Louisa Von Baumgarten
Dupilumab is a new monoclonal antibody inhibiting IL-4 and IL-13 signaling transduction through the blockage of the α-subunit of the IL-4 receptor. It is used to treat type 2 inflammatory disorders including atopic dermatitis, asthma, and chronic rhinosinusitis. Here we describe the case of a 79-year-old male presenting with visual hallucinations, disorientation, cognitive decline, and behavioral changes, evolving over 3 weeks. He had been under treatment with dupilumab for atopic dermatitis for the previous 4 months...
2022: Frontiers in Neurology
https://read.qxmd.com/read/35644583/-acute-sarcoid-myopathy-and-neuropathy-aggravated-by-ustekinumab-administration-in-an-elderly-woman-with-psoriasis-and-systemic-sarcoidosis
#17
JOURNAL ARTICLE
Hironori Sano, Toshihiko Maeda, Ryota Sato, Fumitaka Shimizu, Michiaki Koga, Takashi Kanda
A 72-year old woman, who had a history of psoriasis and psoriatic arthritis from age of 69, was admitted because of acute progression of dyspnea and generalized muscle weakness after initiation of ustekinumab. She had been diagnosed as having lung and eye sarcoidosis ten months before admission. Nerve conduction studies revealed multiple mononeuropathy and needle electromyography showed myogenic changes with spontaneous activities. Muscle pathology showed non-caseating epithelioid granuloma and high expression of HLA-class I in myofibers...
June 24, 2022: Rinshō Shinkeigaku, Clinical Neurology
https://read.qxmd.com/read/35405430/neuro-ophthalmological-manifestations-of-sarcoidosis
#18
JOURNAL ARTICLE
William B Yates, Peter J McCluskey, Clare L Fraser
Neuro-sarcoidosis has important ophthalmic and neuro-ophthalmic manifestations. Sarcoidosis most commonly affects the uveal tract (iris, ciliary body, and choroid) however the optic nerve is commonly involved. Sarcoid related optic neuritis is an important differential diagnosis in optic neuritis especially in atypical presentations. The use of multimodal imaging techniques available in the ophthalmic setting can enable the detection of choroidal or optic nerve granulomas and aid the diagnosis. Efferent manifestations of neuro-sarcoidosis are broad and can range from isolated cranial neuropathies or multiple as well as pupil abnormalities...
June 15, 2022: Journal of Neuroimmunology
https://read.qxmd.com/read/34788239/multiple-cranial-neuropathies-and-pachymeningitis-in-a-patient-with-a-pathogenic-nucleotide-binding-oligomerization-domain-2-polymorphism
#19
JOURNAL ARTICLE
Sravanthi Vegunta, John Bohnsack, Alison Crum, Kathleen Digre, Bradley Katz, Meagan Seay, Edward Quigley, Sean Kennedy, Nick Mamalis, Judith Warner
An 11-year-old boy presented with 2 weeks of intermittent headache, right orbital pain, and constant diplopia. Brain MRI showed dural thickening and enhancement of the right lateral cavernous sinus, right orbital apex, and tentorium. Initial cerebral spinal fluid analysis showed only mild pleocytosis, and serum diagnostics were unrevealing. The working diagnosis was Tolosa-Hunt syndrome. His pain and sixth nerve palsy resolved with corticosteroids. Five months after initial presentation, he developed new numbness of the right cheek, complete right ophthalmoplegia, and weakness and numbness of his right hand and leg, all of which were responsive to steroids...
December 1, 2021: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://read.qxmd.com/read/34764122/rare-presentation-of-sarcoidosis-with-optic-neuropathy-and-third-nerve-palsy
#20
JOURNAL ARTICLE
Mohamed Seifelnasr, Magnus Theodorsson, Jonathan Hart, Eoin O'Sullivan
Sarcoidosis is a systemic, idiopathic and granulomatous disease, which most commonly affects the skin, lungs and lymph nodes but can affect virtually any organ. Neurosarcoidosis can be the presenting or the only clinical manifestation accounting for 5%-15% of sarcoid diagnoses. In contrast to uveitis which is the most common ophthalmic manifestation, neuro-ophthalmic signs are uncommon in sarcoidosis. Optic neuropathy is the most common neuro-ophthalmic sign (70% in one series). Sarcoid-related optic neuropathy commonly presents with a picture similar to optic neuritis...
November 11, 2021: BMJ Case Reports
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