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By EFRAIN PAEZ Internal Medicine since 1988. Interested in all aspects of Medicine.
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
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
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
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
Sonja E Leonhard, Daan Fritz, Filip Eftimov, Anneke J van der Kooi, Diederik van de Beek, Matthijs C Brouwer
The aim of this study was to evaluate clinical characteristics, diagnostic strategy, and treatment in patients with neurosarcoidosis in a tertiary referral centre.In a cross-sectional study, we included all patients with neurosarcoidosis treated at our tertiary referral center between September 2014 and April 2015.We identified 52 patients, among them 1 patient was categorized as having definite neurosarcoidosis, 37 probable neurosarcoidosis, and 14 possible neurosarcoidosis. Neurologic symptoms were the first manifestation of sarcoidosis in 37 patients (71%)...
April 2016: Medicine (Baltimore)
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
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
Jinny O Tavee, Barney J Stern
Neurosarcoidosis is known as the great mimicker and may appear similar to lymphoma, multiple sclerosis, and other diseases affecting the nervous system. Although definitive diagnosis requires histologic confirmation of the affected neural tissue, characteristic clinical manifestations, gadolinium-enhanced MRI patterns and specific cerebrospinal fluid findings can help support the diagnosis in the absence of neural biopsy. An understanding of the common clinical presentations and diagnostic findings is central to the evaluation and management of neurosarcoidosis...
December 2015: Clinics in Chest Medicine
N Touati, M Mansour, I Bedoui, A Kacem, H Derbali, A Riahi, M Messelmani, J Zaouali, N Fekih-Mrissa, R Mrissa
INTRODUCTION: Sarcoidosis is a multisystemic granulomatous disease of unknown aetiology. Neurologic manifestations are found in 5 to 10% of cases. PATIENTS AND METHODS: We conducted a retrospective study over 6-year period including 18 patients diagnosed with neurosarcoidosis in the Neurologic department of the Military Hospital of Instruction of Tunis. Clinical, radiological, therapeutic features and outcome were studied. RESULTS: The mean age was 43...
November 2015: Revue Neurologique
Vedha Sanghi, Aanchal Kapoor
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Lütfi Akyol, Kerim Aslan, Metin Özgen, Mehmet Sayarlioglu
We present a case of a neurosarcoidosis patient with skin lesions. A 50-year-old woman was admitted with a 1-year history of violaceous, smooth and shiny plaques on her face and right arm. These lesions were biopsied and the histological examination indicated sarcoidosis. The patient had a history of headache and syncope that lasted for about 1 h. Brain CT showed masses measuring 37×20 mm in both frontal lobes. Thoracic and abdominal CT showed many pathologically enlarged lymph nodes. The patient was diagnosed with cutaneous, lung and neuronal sarcoidosis, and treated with 20 mg/day methylprednisolone, 15 mg/week methotrexate, 10 mg/week folic acid, 400 mg/day hydroxychloroquine and 800 mg/day carbamazepine...
2015: BMJ Case Reports
G Bathla, A K Singh, B Policeni, A Agarwal, B Case
Sarcoidosis is an idiopathic inflammatory disease that may affect any organ system and have protean manifestations. Neurosarcoidosis refers to involvement of the central nervous system and may occur in patients with known sarcoidosis, or be the initial manifestation of the disease. In the latter, it can be a source of considerable confusion, given the non-specific imaging appearance. The aim of this review is to describe the imaging spectrum of neurosarcoidosis, including follow-up imaging and superimposed infections, which may occur secondary to immunosuppression...
January 2016: Clinical Radiology
Claudio Tana, Susanne Wegener, Ewa Borys, Stefan Pambuccian, Georgi Tchernev, Marco Tana, Maria Adele Giamberardino, Mauro Silingardi
The diagnosis and treatment of neurosarcoidosis can be very challenging for several reasons. It affects clinically 5%-10% of sarcoidosis patients, but can be found in up to 25% of autopsies. These data reveal that a high percentage of asymptomatic or misdiagnosed cases can be missed at an initial diagnostic approach. Clinical and imaging findings are often non-specific since they can be found in a large number of neurological disorders. Histopathology can also be confounding if not performed by an expert pathologist and not placed in an appropriate clinical context...
2015: Annals of Medicine
Nynne Nyboe Andersen, Björn Pasternak, Mikael Andersson, Nete Munk Nielsen, Tine Jess
No abstract text is available yet for this article.
December 2015: JAMA Internal Medicine
Alexander C Wiseman
Immunosuppressive agents are commonly used in the nephrologist's practice in the treatment of autoimmune and immune-mediated diseases and transplantation, and they are investigational in the treatment of AKI and ESRD. Drug development has been rapid over the past decades as mechanisms of the immune response have been better defined both by serendipity (the discovery of agents with immunosuppressive activity that led to greater understanding of the immune response) and through mechanistic study (the study of immune deficiencies and autoimmune diseases and the critical pathways or mutations that contribute to disease)...
February 5, 2016: Clinical Journal of the American Society of Nephrology: CJASN
W Oliver Tobin, Fredric B Meyer, B Mark Keegan
OBJECTIVE: We aimed to determine the diagnostic yield and safety of posterior fossa parenchymal biopsy. METHODS: One-hundred-thirty-six patients who underwent 137 posterior fossa (brainstem or cerebellar) parenchymal biopsies at Mayo Clinic (Rochester, Minnesota, USA) between 1996 and 2009 were identified by chart review. Case histories; radiologic, surgical, and pathologic reports; and safety outcomes were assessed. RESULTS: Posterior fossa parenchymal biopsies were performed on 78 male and 58 female patients of median age 47 years (interquartile range 28-61)...
December 2015: World Neurosurgery
Heather J MacLean, Mohammad Abdoli
The clinical presentation of neurosarcoidosis is varied as multiple levels of the neuraxis may be affected. When central nervous system involvement occurs, making an accurate diagnosis of the condition can be challenging, especially given the current definition for definite neurosarcoidosis requires histologic confirmation of the affected tissue (brain biopsy). This article will review our current knowledge and manifestations of neurosarcoidosis, discuss the current diagnostic approach as well as the challenges associated with a condition requiring histologic confirmation, discuss the current treatment approach, and highlight the challenges of this diagnosis with a few real-life clinical cases...
September 2015: Multiple Sclerosis and related Disorders
Jeremy Anthony, Gregory J Esper, Adriana Ioachimescu
PURPOSE: Hypothalamic-pituitary (HP) neurosarcoidosis (NS) accounts for 0.5 % cases of sarcoidosis and 1 % of HP masses. Correlative data on endocrine and neurological outcomes is lacking. METHODS: Retrospective case series and literature review of presentation, treatment and outcome of HP NS. RESULTS: Our series includes 4 men, ages 34-59, followed for a median of 7.3 years (range 1.5-17). All had optic neuropathy, multiple pituitary hormone abnormalities (PHAs) and other organ involvement by sarcoidosis (lung, sino-nasal, brain/spine and facial nerve)...
February 2016: Pituitary
H Krenzlin, D Jussen, C Musahl, S Scheil-Bertram, K Wernecke, P Horn
Background Sarcoidosis is a systemic disorder of unknown origin characterized by noncaseating granulomas. Clinical symptoms due to central nervous system (CNS) involvement occur in 5 to 7% of all cases; subclinical involvement is more frequent. Sole CNS involvement is very rare. Case Report A 25-year-old man presented with increasing polyuria and polydipsia over 8 weeks. Magnetic resonance imaging (MRI) revealed a supra- and infra-chiasmatic pre-thalamic mass lesion 1.0 × 1.4 × 1.4cm in diameter...
July 2015: Journal of Neurological Surgery Reports
Jeremy Jones, Arjun Gupta, Harris Naina
Central nervous system (CNS) involvement in sarcoidosis is rare and typically occurs in 5-10% of patients. Neurological symptoms in a patient with known sarcoidosis can be attributed to neurosarcoidosis without thorough evaluation. Primary Dural Lymphoma (PDL) is an extremely rare form of non-Hodgkin lymphoma. Although PDL is technically a subtype of primary CNS lymphoma, the two entities vary markedly in their histological grade, clinical course, prognosis and treatment. The most common dural- based lesion found on CNS imaging is meningioma...
2015: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
2015-08-07 15:37:14
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