Neurosarcoidosis in a Middle-aged Man –  a Case Report

Authors: M. Žurková 1;  P. Otruba 2;  V. Lošťáková 1;  Z. Tudos 3;  V. Kolek 1;  E. Kriegová 4
Authors‘ workplace: Klinika plicních nemocí a tuberkulózy LF UP a FN Olomouc 1;  Neurologická klinika LF UP a FN Olomouc 2;  Radiologická klinika LF UP a FN Olomouc 3;  Ústav imunologie, LF UP v Olomouci 4
Published in: Cesk Slov Neurol N 2016; 79/112(2): 225-230
Category: Case Report

Grantová podpora: IGA MZ ČR NT11117.


Sarcoidosis is a multisystem granulomatous disease of unknown origin that rarely affects the nervous system. Granulomatous process may affect all structures of the central and peripheral nervous system. Neurosarcoidosis is associated with bad prognosis and the treatment should be started at early stages of the disease. We present a case of a middle-aged man with sarcoidosis of the peripheral lung lymph nodes and lung parenchyma. After 10 years of follow-up, the disease progressed with cardiac and neurological involvement. The peripheral nervous system was affected with peripheral neuropathy associated with sarcoidosis; other reasons for peripheral neuropathy were excluded. Treatment with corticosteroids led to improvements in neurological symptoms. At present, the patient is on a maintenance dose of corticosteroids, shows low activity of lung disease and neurological findings have been stable throughout the follow-up period. A brief literature review of the latest diagnostic and treatment options in patients with neurosarcoidosis is presented, including the first experience with novel biological treatments of this rare, very serious disease.

Key words:
sarcoidosis – neurosarcoidosis – involvement of central nervous system – peripheral neuropathy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


1. Loštáková V, Kolek V, Vašáková M. Sarkoidóza – doporučený postup diagnostiky, terapie a sledování vývoje onemocnění. Standardy ČPFS –  Sekce pro intersticiální plicní procesy. Dostupné z URL: http:/ / odborne/ doc/ Sarkoidoza.doc.

2. Kolek V. Sarkoidóza: známé a neznámé. Praha: Grada 1998.

3. American Thoracic Society, European Respiratory Society and World Association of Sarcoidosis and Other Granulomatous Disorders. Joint Statement on sarcoidosis. Am J Respir Crit Care Med 1999;160(2):736– 55.

4. Nozaki K, Judson MA. Neurosarcoidosis: clinical manifestations, diagnosis and treatment. Presse Med 2012;41(2):e331– 48. doi: 10.1016/ j.lpm.2011.12.017.

5. Kolek V, Pěničková V, Heřman M, et al. Neurosarcoidosis. Evaluation of new diagnostic methods in early diagnosis and treatment. Cas Lek Ces 1996;135(5):141– 4.

6. Zurková M, Kolek V, Tomankova T, et al. Extrapulmonary involvement in patients with sarcoidosis and comparison of routine laboratory and clinical data to pulmonary involvement. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014;158(4):613– 20. doi: 10.5507/ bp.2014.026.

7. Agnihotri SP, Singhal T, Stern BJ, et al. Neurosarcoidosis. Semin Neurol 2014;34(4):386– 94. doi: 10.1055/ s-0034-1390387.

8. Heerfordt CF. „Über eine „Febris uveo-parotidea subchronica“ an der Glandula parotis und der Uvea des Auges lokalisiert und häufug mit Paresen cerebrospinaler Nerven kompliziert. Albrecht Von Graefes Arch Klin Exp Ophthalmol 1909;70:254– 73.

9. Zámecník J, Ambler Z, Ehler E, et al. Granulomatous myopathy in patients with sarcoidosis and myasthenia gravis. Cesk Patol 2006;42(4):175– 81.

10. Bagnato F, Stern BJ. Neurosarcoidosis: diagnosis, therapy and biomarkers. Expert Rev Neurother 2015;15(5):533– 48. doi: 10.1586/ 14737175.2015.1037288.

11. Hoyle JC, Jablonski C, Newton HB. Neurosarcoidosis: clinical review of a disorder with challenging in patient presentations and diagnostic considerations. Neurohospitalist 2014;4(2):94– 101. doi: 10.1177/ 1941874413519447.

12. Tana C, Wegener S, Borys E, et al. Challenges in the diagnosis and treatment of neurosarcoidosis. Ann Med 2015;47(7):576– 91. doi: 10.3109/ 07853890.2015.1093164.

13. Doty JD, Mazur JE, Judson MA. Treatment of sarcoidosis with infliximab. Chest 2005;127(3):1064– 71.

14. Marques I, Giovannonni G, Marta M. Mononeuritis multiplex as the first presentation of refractory sarcoidosis responsive to etanercept. BMC Neurol 2014;14:237. doi: 10.1186/ s12883-014

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