Clinical Manifestations of Neurosarcoidosis in the Netherlands

Abstract

Background: Neurosarcoidosis is a rare disease. We investigated the prevalence of different manifestations of neurosarcoidosis and the influence of race or gender in the Netherlands, as well as the treatment strategies for neurosarcoidosis patients. Methods: Multicentre observational cohort study of patients with neurosarcoidosis in two tertiary referral centres; the

Neurosarcoidosis with hydrocephalus as a first presenting sign: a unique case report

“…Typically, initial treatment consists of corticosteroids, although the exact mechanism is still unknown. It is hypothesized that the benefit is due to the anti‐inflammatory and immune‐modulating effects 11,19 . The benefit of this treatment varies widely from substantial improvement to no improvement at all.…”

“…It is hypothesized that the benefit is due to the anti-inflammatory and immune-modulating effects. 11,19 The benefit of this treatment varies widely from substantial improvement to no improvement at all. As a second step, a steroid-sparing or second-line agent, like Methotrexate (MTX) or mycophenolate can be considered.…”

“…When the need for immunosuppressive treatment is chronic, upfront start of combination therapy of both corticosteroids and a steroid‐sparing or second‐line agent can be preferred. Further treatment options include TNF‐alpha inhibitors such as infliximab, although treatment is expensive and poses a higher risk for infections and other toxicities 9,19 …”

Case report: Neurosarcoidosis with hydrocephalus as a first presenting sign.

“…Typically, initial treatment consists of corticosteroids, although the exact mechanism is still unknown. It is hypothesized that the benefit is due to the anti-inflammatory and immunemodulating effects 11,19 . The benefit of this treatment varies widely from substantial improvement to no improvement at all.…”

“…When the need for immunosuppressive treatment is chronic, upfront start of combination therapy of both corticosteroids and a steroid-sparing or second-line agent can be preferred. Further treatment options include TNF-alpha inhibitors such as infliximab, although treatment is expensive and poses a higher risk for infections and other toxicities 9,19 .…”