Neurosarcoidosis in a public safety net hospital: a study of 82 cases.
Sarcoidosis Vasc Diffuse Lung Dis
; 36(1): 25-32, 2019.
Article
em En
| MEDLINE
| ID: mdl-32476933
ABSTRACT
OBJECTIVE:
To characterize clinical presentation, laboratory and imaging data, and treatment outcomes for neurosarcoidosis in an urban safety net hospital.METHODS:
The research database of Cook County Health and Hospitals system was queried for all cases of sarcoidosis from 2006 to 2013. These cases plus those identified through a survey of neurology faculty were reviewed and flagged if suspected to be neurosarcoidosis. Data were extracted in a standardized fashion, upon review by two experienced neurologists; patients were classified as definite, probable or possible neurosarcoidosis. Disagreements on classification were resolved by consensus conference.RESULTS:
1706 cases of sarcoidosis were identified, with 82 (4.8%) classified as neurosarcoidosis. The cohort was predominantly African American (89%). Six were classified as definite, 34 as probable, and 42 as possible neurosarcoidosis. Neurosarcoidosis was the presenting symptom of sarcoidosis in 74% of cases. The most common presenting phenotype was myelopathy (21.7%), followed by optic nerve/chiasm involvement (16.0%) and epilepsy (11.3%). The facial nerve was involved in only 2% of cases. Chest x-ray showed abnormalities of sarcoidosis in 43.3% of cases, while chest CT did so in 78.6%. Corticosteroids were the initial treatment in 91% of cases, and outcomes were good in 53% of cases.CONCLUSION:
Neurosarcoidosis remains a challenging diagnosis with the majority of patients without a previous diagnosis of systemic sarcoidosis. Chest imaging was supportive of the diagnosis in a majority of patients. Our cohort differs from others in the literature due to a low prevalence of facial nerve involvement. Prospective registry studies are needed.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Sarcoidose
/
Doenças do Sistema Nervoso Central
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Provedores de Redes de Segurança
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Hospitais Públicos
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Sarcoidosis Vasc Diffuse Lung Dis
Assunto da revista:
ALERGIA E IMUNOLOGIA
/
ANGIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article