#153 Neurosarcoidosis: The 21st century great mimicker
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Description
In the TV show, HOUSE, it's either lupus or its sarcoidosis. Only, it's never sarcoidosis. That's because sarcoidosis is such a heterogeneous condition and can affect practically any age group. In some patients, this idiopathic inflammatory disorder can also involve the nervous system. Also causing a variety of signs and symptoms ranging from mild headache to a proximal myopathy or even a CNS vasculitis. This week on the BrainWaves podcast, Dr. Jesse Thon reflects on the literature and shares his experience managing patients with this troubling condition. Produced by Jesse Thon and James E. Siegler. Music courtesy of Steve Combs, Lovira, and Yakov Goldman. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Petereit HF, Reske D, Tumani H, Jarius S, Markus Leweke F, Woitalla D, Pfister HW and Rubbert A. Soluble CSF interleukin 2 receptor as indicator of neurosarcoidosis. Journal of neurology. 2010;257:1855-63. Agnihotri SP, Singhal T, Stern BJ and Cho TA. Neurosarcoidosis. Semin Neurol. 2014;34:386-94. Bitoun S, Bouvry D, Borie R, Mahevas M, Sacre K, Haroche J, Psimaras D, Pottier C, Mathian A, Hie M, Boutin DL, Papo T, Godeau B, Valeyre D, Nunes H, Amoura Z and Cohen Aubart F. Treatment of neurosarcoidosis: A comparative study of methotrexate and mycophenolate mofetil. Neurology. 2016;87:2517-2521. Gelfand JM, Bradshaw MJ, Stern BJ, Clifford DB, Wang Y, Cho TA, Koth LL, Hauser SL, Dierkhising J, Vu N, Sriram S, Moses H, Bagnato F, Kaufmann JA, Ammah DJ, Yohannes TH, Hamblin MJ, Venna N, Green AJ and Pawate S. Infliximab for the treatment of CNS sarcoidosis: A multi-institutional series. Neurology. 2017;89:2092-2100. Jolliffe EA, Keegan BM and Flanagan EP. Trident sign trumps Aquaporin-4-IgG ELISA in diagnostic value in a case of longitudinally extensive transverse myelitis. Mult Scler Relat Disord. 2018;23:7-8. Wallaert B, Ramon P, Fournier EC, Hatron PY, Muir JF, Tonnel AB and Voisin C. High-dose methylprednisolone pulse therapy in sarcoidosis. Eur J Respir Dis. 1986;68:256-62. Agbogu BN, Stern BJ, Sewell C and Yang G. Therapeutic considerations in patients with refractory neurosarcoidosis. Archives of neurology. 1995;52:875-9. Baughman RP and Lower EE. Infliximab for refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2001;18:70-4. Baughman RP, Drent M, Kavuru M, Judson MA, Costabel U, du Bois R, Albera C, Brutsche M, Davis G, Donohue JF, Muller-Quernheim J, Schlenker-Herceg R, Flavin S, Lo KH, Oemar B, Barnathan ES and Sarcoidosis I. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006;174:795-802. Rossman MD, Newman LS, Baughman RP, Teirstein A, Weinberger SE, Miller W, Jr. and Sands BE. A double-blinded, randomized, placebo-controlled trial of infliximab in subjects with active pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2006;23:201-8.
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