Case report

Bajantri, Bharat; Venkatram, Sindhaghatta; Niazi, Masooma; Singh, Tamanna; Diaz‐Fuentes, Gilda

doi:10.1097/md.0000000000008516

Cited by 4 publications

(4 citation statements)

References 61 publications

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“…However, in one research, steroid-resistant neurosarcoidosis which failed to respond to infliximab alone responded to the addition of IVIG to the regimen. In different presentations of the neurosarcoidosis, such as multiple conduction blocks and small fiber neuropathy, which were resistant to first-line and second-line therapeutic agents responded to IVIGs [9]. Our patient responded very well to the addition of IVIG supporting the result of other reported cases [7,10].…”

Section: Discussionsupporting

confidence: 80%

Isolated Bulbar Palsy: A Rare Presentation of Neurosarcoidosis

Chaudhry

Ata

Abdelghani

et al. 2020

Cureus

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Sarcoidosis, which is a non-caseating granulomatous chronic inflammatory disease, can affect virtually any organ system, including the central nervous system (CNS). Very rarely, patients may present solely with neurosarcoidosis. It commonly presents with unilateral or bilateral seventh nerve palsy. Rarely it can present as dangerous progressive bulbar palsy and is a diagnostic and clinical challenge. We present a case of sarcoidosis with a unique presentation of isolated bulbar palsy. A 38-year-old male presented to the emergency with a sudden onset of dysphonia followed by dysphagia for both solids and liquids for one week and 5 kg weight loss in two months. The rest of the CNS exam was unremarkable. On labs, he had hypercalcemia and suppressed parathyroid hormone (PTH) intact. Detailed radiological investigations, lab tests, and lymph node biopsy helped confirm the diagnosis of neurosarcoidosis. The patient did not respond to first-line steroid therapy and hence received intravenous immunoglobulin (IVIG) subsequently with adequate response and complete neurologic recovery, confirmed by a follow-up visit.

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Section: Discussionsupporting

confidence: 80%

Isolated Bulbar Palsy: A Rare Presentation of Neurosarcoidosis

Chaudhry

Ata

Abdelghani

et al. 2020

Cureus

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“…Neurosarcoidosis presents symptoms such as meningitis, seizures, neuroendocrine symptoms, and neuropsychiatric symptoms (4).…”

Section: Introductionmentioning

confidence: 99%

“…Data on the disease burden of sarcoidosis in Ghana is not readily available. However, a number of cases have been reported such as that by Bajantri et al who reported on a 53-year-old woman with neurosarcoidosis [ 4 ] and two cases of cardiac sarcoidosis in a 51-year-old man and a 58-year-old woman reported by Afriyie-Mensah et al [ 5 ]. It is more common in females [ 1 ], and the age at diagnosis is usually between 40 and 55 years [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Exertional Dyspnea Incidentally Diagnosed as Sarcoidosis: A Teaching Hospital Experience

Nartey,

Ulzen-Appiah

2023

Case Reports in Pulmonology

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Background. Sarcoidosis is a complex disease with nonspecific etiology and clinical presentation. Its diagnosis is often delayed due to the absence of a single specific investigation modality. A multidisciplinary approach is necessary for its diagnosis. Report. A 49-year-old male presented with recurrent dyspnea on exertion, easy fatigue, and chest pain after several visits to different health facilities over 5 months. A diagnosis of pulmonary sarcoidosis was made after a series of laboratory and imaging investigations were done revealing bilateral reticonodular opacifications, noncaseating granulomata, elevated serum ACE and calcium levels consistent with sarcoidosis. Conclusion. Sarcoidosis, although a rare presentation in our setting, may easily be overlooked or misdiagnosed if a holistic or multidisciplinary approach is not employed in its diagnosis. Nonspecificity of symptoms contributes to the delayed diagnosis.

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A Case of Neurosarcoidosis Mimicking Brain Tumor

Sarı

Peker

Çeşme

et al. 2021

CMIR

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Background: Neurosarcoidosis manifests symptomatically in 5% of patients with sarcoidosis and diagnosis can be challenging if not clinically suspected. Cerebral mass-like presentation of neurosarcoidosis rarely reported in the literature. We presented a woman with neurosarcoidosis who had a cerebral mass-like lesion which completely disappeared after medical treatment. Discussion: A 37-year-old woman with history of pulmonary sarcoidosis referred to the emergency service of our hospital with a one-month history of progressive dizziness, nausea and seeing flashing lights. At neurologic examination, numbness and weakness on the left side of the body, deviation of uvula toward the right side was seen. Cranial MRI demonstrated a 2.5x2 cm in size mass lesion which hypointense on T1 WI, heterogeneous hyperintense on T2 and FLAIR sequence with peripheral vasogenic edema and heterogeneous, irregular contrast enhancement simulating brain tumor. Also, leptomeningeal and nodular contrast enhancement was seen on brainstem, cerebellar vermis, perimesencephalic cistern and left frontal, bilateral parietooccipital sulcus. In laboratory tests; The level of serum angiotensin-converting enzyme (ACE) was 53 IU/mL (N:8-52 IU/mL) and cerebrospinal fluid (CSF) ACE was 23 IU/mL (N:0-2.6 IU/mL). CSF cytology analysis was normal. Pattern 2 oligoclonal bands were present. With these clinical, laboratory and radiological findings, cerebral involvement of sarcoidosis was suspected. Biopsy was not performed due to the high risk of morbidity caused by the deep location of the lesion.Patient was treated with methylprednisolone and Azathioprine for a month.On post-treatment control imaging; lesion disappeared completely without residual leptomeningeal and nodular contrast enhancement.Also, neurologic symptoms were decreased remarkably. Conclusion: Multi-system inflammatory disorders like sarcoidosis, can present with mass-like lesion in the brain parenchyma. While early diagnosis is important to prevent unnecessary interventions like biopsy and surgery, it is crucial to initiate the necessary treatment with the aim of recovery without sequelae. Radiological and clinical follow-up are fundamental in differential diagnosis.

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Case report

Cited by 4 publications

References 61 publications

Isolated Bulbar Palsy: A Rare Presentation of Neurosarcoidosis

Isolated Bulbar Palsy: A Rare Presentation of Neurosarcoidosis

Exertional Dyspnea Incidentally Diagnosed as Sarcoidosis: A Teaching Hospital Experience

A Case of Neurosarcoidosis Mimicking Brain Tumor

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