Presentation
most commonly, it presents as cranial neuropathy, but presentation ranges from encephalopathy, meningitis, hydrocephalus, and seizure to spinal cord dysfunction, peripheral neuropathy, and myopathy. 2, 3, 4, 10 Only rare cases of neurosarcoidosis presenting [ajnr.org]
Here, we present a case of isolated neurosarcoidosis that initially presented with hydrocephalus requiring ventriculoperitoneal shunt placement. [nnjournal.net]
Splenomegaly is present in about 17%. In approximately12%, osseous granulomas are present, most commonly in the phalanges of the fingers and toes. Involved phalanges appear swollen and deformed, often sausage-shaped. [dermaamin.com]
Case Report Mrs BM, a 52 year old lady presented in March 2008 to the ENT department at Royal Glamorgan Hospital, South Wales. [ispub.com]
About a third will have a nonspecific presentation with fever, fatigue, cachexia and lassitude and this presentation is more common in people of black or Indian origin. [patient.info]
Skin
- Hypopigmented Macule
Hypopigmented macules in an Indian man Arch Dermatol 2006 ; 142 : 1643-1648 [cross-ref] [74] Hall R.S., Floro J.F., King L.E. Hypopigmented lesions in sarcoidosis J Am Acad Dermatol 1984 ; 11 : 1163-1164 [cross-ref] [75] Nozaki T. [em-consulte.com]
Workup
This case highlights the importance of tissue diagnosis and the diagnostic workup for sarcoidosis in cases of cryptogenic hydrocephalus. [nnjournal.net]
She was diagnosed with idiopathic intracranial hypertension and referred to a neurologist for further workup and management. The neurologist performed a lumbar puncture which showed an elevated opening pressure of 50 cm H 2 O. [eyerounds.org]
Definitive diagnosis of neurosarcoidosis requires the exclusion of other causes of neuropathy and the identification of noncaseating sarcoid granulomas by histologic analysis of nerve and muscle biopsy specimens (see Workup). [emedicine.medscape.com]
"Sarcoidosis Workup". Medscape Reference. WebMD. Archived from the original on 1 March 2014. Retrieved 19 February 2014. ^ Allmendinger A, Perone R (2009). "Case of the Month". Diagnostic Imaging. 31 (9): 10. ^ Joanne Mambretti (2004). [en.wikipedia.org]
Foreign bodies in granulomatous cutaneous lesions and sarcoidosis are not mutually exclusive and, therefore, a workup to exclude systemic sarcoidosis should be undertaken [ 20, 25, 26, 27, 28, 29, 30, 31, 32 ]. [em-consulte.com]
Other Pathologies
- Granulomatous Tissue
Patient was subjected to FNAC thyroid which revealed ill-formed elements of granulomatous tissue. Patient refused to undergo the biopsy of the thyroid gland. [ijem.in]
Granulomatous production of parathyroid-hormone related protein (PTH-rP) may also play a role in abnormal calcium metabolism, 4 where tissue necrosis factor-alpha (TNF-α) and interleukin-6, produced by macrophages, increase PTH-rP gene expression. 4 PTH-rP [academic.oup.com]
Treatment
[…] in the 4-mg treatment group showed a significant increase compared with placebo ( P =.012). [clinicalpainadvisor.com]
At this time, there is no consistently effective treatment for necrobiosis lipoidica. Treatment options include corticosteroids, fibrinolytics, antiplatelet agents, and surgical treatments (i.e. excision and grafting). [bobbybukamd.com]
A variety of treatments for IIH have been proposed and there is much anecdotal evidence for these treatments. [eyerounds.org]
[…] as a treatment for cases with liver involvement. [113] Thalidomide has also been tried successfully as a treatment for treatment-resistant lupus pernio in a clinical trial, which may stem from its anti-TNF activity, although it failed to exhibit any [en.wikipedia.org]
He did not respond to aggressive antithrombotic treatment. [ncbi.nlm.nih.gov]
Prognosis
Seite 117 - Pulmonary sarcoidosis: role of CT in the evaluation of disease activity and functional impairment and in prognosis assessment. Radiology 191 (3): 675-680 141. [books.google.de]
May portend prognosis. Classified as: Specific (lesions contain granulomas) Non-specific (lesions are reactive processes and do not contain granulomas). 18. [slideshare.net]
They may be interpreted as a defense reaction against a tumor’s antigens, and may have a more favorable prognosis than classical malignant nodes. [omicsonline.org]
Early sarcoid arthritis is often self-limited, lasting for days to months, and the prognosis is excellent. [rheumaknowledgy.com]
Prognosis The prognosis of patients with sarcoidosis mainly depends on the extent and severity of the systemic involvement [ 15, 17, 18, 20 ]. [em-consulte.com]
Etiology
A discussion of the etiology, diagnosis, systemic and ocular manifestations, and treatment of sarcoidosis is presented. Format: video Series: Moran Eye Center Grand Rounds Identifier: Moran_CORE_21552 Copyright statement: Copyright 2016. [morancore.utah.edu]
Etiology: Although exposure to an infectious organism or some other environmental agent has long been hypothesized to be etiologically relevant to the disease, none has been conclusively implicated. [rheumaknowledgy.com]
Etiology and Clinical Diagnosis The etiologies of microscopic hematuria are numerous and range from clinically insignificant causes to potentially life-threatening neoplastic lesions 5 ( Table 1 2, 3, 7 – 9 ). [aafp.org]
Etiology Despite multiple investigations, the cause of sarcoidosis remains unknown. Currently, the most likely etiology is an infectious or noninfectious environmental agent that triggers an inflammatory response in a genetically susceptible host. [what-when-how.com]
Keywords Sarcoidosis; Schwannoma; Tumor; Benign Introduction Sarcoidosis is a multisystemic granulomatous disorder characterized by non caseating granulomas, of undetermined etiology, with bilateral mediastinal lymphadenopathy, pulmonary infiltration, [omicsonline.org]
Epidemiology
Gastroenterology, 127, S5-S16. [ 2 ] El-Serag, H.B. (2002) Hepatocellular carcinoma: An epidemiologic view. [scirp.org]
Epidemiology ► Exact prevalence (estimated at 10 to 20 per 100,000 population). ► Annual incidence of sarcoidosis are not known with certainty ► Incidence peaks in winter and early spring. Women greater incidence. [slideshare.net]
James DG, Hosoda Y: Epidemiology. In: James DG, ed. Sarcoidosis and other granulomatous disorders. New York, Marcel Dekker; 1994 :729–43 2. Stern BJ: Neurological complications of sarcoidosis. Curr Opin Neurol; 2004:17:311-6 3. [ispub.com]
Epidemiology [ edit ] The prevalence of sarcoid is estimated to be 10 to 20 per 100,000 people. [en.wikibooks.org]
"The epidemiology of sarcoidosis in Rochester, Minnesota: a population-based study of incidence and survival" (PDF). American Journal of Epidemiology. 123 (5): 840–5. doi : 10.1093/oxfordjournals.aje.a114313. [en.wikipedia.org]
Pathophysiology
Posterior reversible encephalopathy syndrome, part 2: Controversies surrounding pathophysiology of vasogenic edema. Am J Neuroradiol 2008;29:1043-9. [ PUBMED ] [ FULLTEXT ] 7. Saigal G, Bhatia R, Bhatia S, Wakhloo AK. [annalsofian.org]
ARA 290 relieves pathophysiological pain by targeting TRPV1 channel: Integration between immune system and nociception. Peptides. 2016;76:73-79. doi: 10.1016/j.peptides.2016.01.003 Heij L, Niesters M, Swartjes M, et al. [clinicalpainadvisor.com]
Pathophysiology [ edit ] The diagnosis of sarcoid is based on compatible clinical and radiographic findings, supportive laboratory data (elevated ACE levels, anergy, elevated serum gamma globulins, positive Kveim test), and evidence of noncaseating granulomas [en.wikibooks.org]
Pathophysiology and Immunopathogenesis The granuloma is the pathologic hallmark of sarcoidosis. A distinct feature of sarcoidosis is the local accumulation of inflammatory cells. [what-when-how.com]
Pathophysiology In IIH, there is no structural obstruction to the circulation of CSF. [eyerounds.org]
Prevention
Reducing Risk & Slowing Down the Disease Sarcoidosis can’t currently be cured, but it can be managed to prevent other problems, such as heart failure, from developing over time. [heart.templehealth.org]
Major goal : prevent fibrosis. Steroids first line : Help prevent fibrosis. Scarring cutaneous lesions Hypercalcemia Severe lung disease Liver disease Cardiac inflammation Posterior uveitis Neurosarcoidosis Severe sarcoidosis of other organs 46. [slideshare.net]
Prevention Although sarcoidosis cannot be prevented, some preventative measures may reduce complications. For example: Influenza vaccination. Osteoporosis prophylaxis (steroid usage). [patient.info]
Although primary prevention studies suggest that cholecalciferol is not entirely effective in preventing glucocorticoid-induced bone loss, 16 it is well tolerated by patients, and can be used once hypercalcaemia has been excluded. [academic.oup.com]
Prevention Prevention Because the cause of transient global amnesia is unknown and the rate of recurrence is low, no standard approaches for preventing the condition exist. [go2jo.com]