Sarcoidosis of the pleura: A case report

Jovanović, Dragana; Vucinic, Violeta; Stevic, Ruza; Roksandić-Milenković, Marina; Samardžić, Natalija; Velinovic, Marta; Stjepanović, Mihailo

doi:10.2298/vsp1405506j

Cited by 6 publications

(2 citation statements)

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“…Radi što objektivnije dijagnostike kao i standardizacije testova i kriterijuma za dijagnozu neurosarkoidoze, Američki nacionalni kardiopulmonalni i hematološki institut predložio je kriterijume za dijagnozu sarkoidoze u slučajevima već poznate lokalizacije i patohistološki potvrđene sarkoidoze drugog organa [25,26].…”

Section: Dijagnoza Neurosarkoidozeunclassified

Clinical manifestations of neurosarcoidosis

et al. 2013

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Introduction. Sarcoidosis affects the central nervous system more frequently than it was previously believed. Since the diagnosis of neurosarcoidosis is often delayed, it may result in serious complications. Being non-specific when present, the symptoms may be subtle and resemble those of other neurological diseases. While the cranial nerves are most frequently affected, neurosarcoidosis can involve other nervous system tissues including the meninges, brain parenchyma (especially the hypothalamic region), spinal cord, peripheral nerve and muscle. Discussion and Review of Literature. During the past decade, a significant progress was made in understanding the epidemiology and pathophysiology of neurosarcoidosis, as well as the possibility to diagnose and treat this disease. Studies have shown that the optimal diagnostic imaging modality for neurosarcoidosis is magnetic resonance imaging with gadolinium because it enhances visualization of granulomatous infiltration in neural tissue. Subclinical neurosarcoidosis may not be uncommon in patients with sarcoidosis. It is now evident that neurosarcoidosis does not invariably present as a catastrophic event. Adverse effects associated with high-dose systemic corticosteroids, the standard therapy, have discouraged practitioners from initiating treatment in the absence of significant symptomatic neurological disease. However, other immunosuppressive agents as well newer biologic agents have emerged as an effective, well-tolerated therapeutic alternative to corticosteroids, which are often effective in corticosteroid- recalcitrant cases. Conclusion. Neurosarcoidosis, as a localized granulomatous disease, is possible and not so rare. Early recognition of neurological involvement in patients with undiagnosed or diagnosed sarcoidosis is crucial to prevent complications, which can sometimes be life-threatening. [Projekat Ministarstva nauke Republike Srbije, br. 175046 i br. 175081]

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Section: Dijagnoza Neurosarkoidozeunclassified

Clinical manifestations of neurosarcoidosis

et al. 2013

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“…However, the actual prevalence of subclinical disease may be higher. Postmortem studies suggest that only half of neurosarcoidosis cases are diagnosed during lifetime, before autopsy 2,3 . Symptoms are not specific, and may resemble those of other neurological diseases 4,5 .…”

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confidence: 99%

Unusual Clinical Course of Neurosarcoidosis Manifested with Acute Hydrocephalus

Jovanović

2021

ACC

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Approximately 5% to 15% of patients with systemic sarcoidosis develop neurological complications. However, the actual prevalence of subclinical disease may be higher. Symptoms are not specific, and may resemble those of other neurological diseases. Hydrocephalus occurs in 6% of patients with neurosarcoidosis. Acute hydrocephalus is extremely rare and when it occurs, it is usually difficult to diagnose, thus leading to possible complications. We present a patient who developed acute hydrocephalus due to neurosarcoidosis, for which he had to be operated on; soon after the operation, cranial infection developed that required definitive drainage system and ventriculoperitoneal shunt had to be implanted. In further complicated clinical course, after four years on corticosteroid therapy (corticosteroid dependent sarcoidosis), he had to be urgently operated on because of significant ventricular catheter adhesions, but several days after the operation he died in coma because of progressive brain edema not responding to treatment. As hydrocephalus due to neurosarcoidosis has high morbidity and mortality, early diagnosis and proper treatment are of utmost importance.

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