Two cases of sarcoidosis presenting as longitudinally extensive transverse myelitis

Clinical Rheumatology
Amanda Mary ScottRobert Kalish

Abstract

Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment. Given its rarity and the diversity of possible manifestations, establishing the diagnosis of spinal cord sarcoidosis is often very difficult. Extensive evaluation must be conducted to rule out primary neurologic, primary rheumatologic, infectious, and neoplastic diseases. MRI often demonstrates hyperintensity on T2-weighted images and enhancement following gadolinium administration. CSF analysis most consistently shows a lymphocytic pleocytosis and elevated proteins. While these less invasive investigations may be helpful, the gold standard for diagnosis is biopsy of neurologic or non-neurologic tissue confirming t...Continue Reading

References

Apr 21, 1999·QJM : Monthly Journal of the Association of Physicians·J P ZajicekD Mitchell
Apr 13, 2011·Current Infectious Disease Reports·John J Halperin
Jun 2, 2015·Journal of the Neurological Sciences·Lei Wang, Yuebing Li
Oct 16, 2015·Annals of Medicine·Claudio TanaMauro Silingardi
Jul 19, 2017·Journal of the Neurological Sciences·Gonçalo CaçãoErnestina Santos
Oct 25, 2017·Rheumatic Diseases Clinics of North America·Patompong Ungprasert, Eric L Matteson
Dec 27, 2017·Expert Review of Anti-infective Therapy·John J Halperin

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Citations

Feb 20, 2021·Case Reports in Neurological Medicine·Nesreen JaafarAchraf Makki

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