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Semin Respir Crit Care Med 2017; 38(04): 499-513
DOI: 10.1055/s-0037-1604165
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neurosarcoidosis

Daniel A. Culver
1   Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
,
Manuel L. Ribeiro Neto
1   Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
,
Brandon P. Moss
2   Neurologic Institute, Cleveland Clinic, Cleveland, Ohio
,
Mary A. Willis
2   Neurologic Institute, Cleveland Clinic, Cleveland, Ohio
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
27. Juli 2017 (online)

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Abstract

Neurosarcoidosis is an uncommon but clinically significant manifestation that will be routinely encountered in sarcoidosis specialty clinics. Overall, neurologic involvement is recognized in 5 to 10% of individuals with sarcoidosis. Neurologic symptoms will be the presenting manifestation of sarcoidosis in approximately one-half of those with neurosarcoidosis. The clinical and imaging features of neurosarcoidosis vary widely, largely depending on the anatomic distribution of the disease. The likelihood of spontaneous resolution is lower than for sarcoidosis in general, and residual functional deficits are not uncommon. Therefore, most patients with neurosarcoidosis require immunosuppressive therapy. Small fiber neuropathy, a recently recognized nongranulomatous parasarcoidosis syndrome, is prevalent in chronic sarcoidosis. The variety of neurologic manifestations, broad differential diagnosis, and complexity of management render neurosarcoidosis an area best served by multidisciplinary teams. Sarcoidologists, neurologists, radiologists, neurosurgeons, endocrinologists, urologists, physiatrists, and physical/occupational therapists all potentially have important roles.

Keywords

neurosarcoidosis - granuloma - meningitis - myelopathy - central nervous system - neuropathy - cranial nerve
 

  • References

  • 1 Lower EE, Broderick JP, Brott TG, Baughman RP. Diagnosis and management of neurological sarcoidosis. Arch Intern Med 1997; 157 (16) 1864-1868
    CrossrefPubMedGoogle Scholar
  • 2 Stern BJ, Krumholz A, Johns C, Scott P, Nissim J. Sarcoidosis and its neurological manifestations. Arch Neurol 1985; 42 (09) 909-917
    CrossrefPubMedGoogle Scholar
  • 3 Baughman RP, Teirstein AS, Judson MA. , et al; Case Control Etiologic Study of Sarcoidosis (ACCESS) research group. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001; 164 (10, Pt 1): 1885-1889
    CrossrefPubMedGoogle Scholar
  • 4 Fritz D, van de Beek D, Brouwer MC. Clinical features, treatment and outcome in neurosarcoidosis: systematic review and meta-analysis. BMC Neurol 2016; 16 (01) 220
    CrossrefPubMedGoogle Scholar
  • 5 Iwai K, Tachibana T, Takemura T, Matsui Y, Kitaichi M, Kawabata Y. Pathological studies on sarcoidosis autopsy. I. Epidemiological features of 320 cases in Japan. Acta Pathol Jpn 1993; 43 (7-8): 372-376
    PubMedGoogle Scholar
  • 6 Waxman JS, Sher JH. The spectrum of central nervous system sarcoidosis. A clinical and pathologic study. Mt Sinai J Med 1979; 46 (03) 309-317
    PubMedGoogle Scholar
  • 7 Nowak DA, Widenka DC. Neurosarcoidosis: a review of its intracranial manifestation. J Neurol 2001; 248 (05) 363-372
    CrossrefPubMedGoogle Scholar
  • 8 Chapelon C, Ziza JM, Piette JC. , et al. Neurosarcoidosis: signs, course and treatment in 35 confirmed cases. Medicine (Baltimore) 1990; 69 (05) 261-276
    CrossrefPubMedGoogle Scholar
  • 9 Zajicek JP, Scolding NJ, Foster O. , et al. Central nervous system sarcoidosis--diagnosis and management. QJM 1999; 92 (02) 103-117
    CrossrefPubMedGoogle Scholar
  • 10 Leonhard SE, Fritz D, Eftimov F, van der Kooi AJ, van de Beek D, Brouwer MC. Neurosarcoidosis in a tertiary referral center: a cross-sectional cohort study. Medicine (Baltimore) 2016; 95 (14) e3277
    CrossrefPubMedGoogle Scholar
  • 11 Nozaki K, Scott TF, Sohn M, Judson MA. Isolated neurosarcoidosis: case series in 2 sarcoidosis centers. Neurologist 2012; 18 (06) 373-377
    CrossrefPubMedGoogle Scholar
  • 12 Inoue Y, Inui N, Hashimoto D. , et al. Cumulative incidence and predictors of progression in corticosteroid-naive patients with sarcoidosis. PLoS One 2015; 10 (11) e0143371
    CrossrefPubMedGoogle Scholar
  • 13 Christoforidis GA, Spickler EM, Recio MV, Mehta BM. MR of CNS sarcoidosis: correlation of imaging features to clinical symptoms and response to treatment. AJNR Am J Neuroradiol 1999; 20 (04) 655-669
    PubMedGoogle Scholar
  • 14 Judson MA, Baughman RP, Thompson BW. , et al; ACCESS Research Group. Two year prognosis of sarcoidosis: the ACCESS experience. Sarcoidosis Vasc Diffuse Lung Dis 2003; 20 (03) 204-211
    PubMedGoogle Scholar
  • 15 Oksanen V. Neurosarcoidosis: clinical presentations and course in 50 patients. Acta Neurol Scand 1986; 73 (03) 283-290
    PubMedGoogle Scholar
  • 16 Pawate S, Moses H, Sriram S. Presentations and outcomes of neurosarcoidosis: a study of 54 cases. QJM 2009; 102 (07) 449-460
    CrossrefPubMedGoogle Scholar
  • 17 Raza N, Schreck KC. Neurosarcoidosis presenting with recurrent strokes: a case report and literature review. Neurohospitalist 2017; 7 (02) 91-95
    PubMedGoogle Scholar
  • 18 Brisman JL, Hinduja A, McKinney JS, Gerhardstein B. Successful emergent angioplasty of neurosarcoid vasculitis presenting with strokes. Surg Neurol 2006; 66 (04) 402-404
    CrossrefPubMedGoogle Scholar
  • 19 Delaney P. Neurologic manifestations in sarcoidosis: review of the literature, with a report of 23 cases. Ann Intern Med 1977; 87 (03) 336-345
    CrossrefPubMedGoogle Scholar
  • 20 James DG, Sharma OP. Neurosarcoidosis. Proc R Soc Med 1967; 60 (11, Part 1): 1169-1170
    PubMedGoogle Scholar
  • 21 Oksanen V, Salmi T. Visual and auditory evoked potentials in the early diagnosis and follow-up of neurosarcoidosis. Acta Neurol Scand 1986; 74 (01) 38-42
    CrossrefPubMedGoogle Scholar
  • 22 Carlson ML, White Jr JR, Espahbodi M. , et al. Cranial base manifestations of neurosarcoidosis: a review of 305 patients. Otol Neurotol 2015; 36 (01) 156-166
    CrossrefPubMedGoogle Scholar
  • 23 Bansal S, Yin K, Vishwanath M, Doran H, Laitt R, Ansons A. Isolated pupil-involving third nerve palsy as the first presentation of sarcoidosis. Neuroophthalmology 2014; 38 (05) 278-280
    CrossrefPubMedGoogle Scholar
  • 24 Bangiyev L, Kornacki S, Mikolaenko I. Rare isolated trigeminal nerve sarcoidosis mimicking schwannoma. Clin Imaging 2015; 39 (01) 133-135
    CrossrefPubMedGoogle Scholar
  • 25 Shah R, Roberson GH, Curé JK. Correlation of MR imaging findings and clinical manifestations in neurosarcoidosis. AJNR Am J Neuroradiol 2009; 30 (05) 953-961
    CrossrefPubMedGoogle Scholar
  • 26 Benzagmout M, Boujraf S, Góngora-Rivera F, Bresson D, Van-Effenterre R. Neurosarcoidosis which manifested as acute hydrocephalus: diagnosis and treatment. Intern Med 2007; 46 (18) 1601-1604
    CrossrefPubMedGoogle Scholar
  • 27 Colover J. Sarcoidosis with involvement of the nervous system. Brain 1948; 71 (Pt. 4): 451-475
    CrossrefPubMedGoogle Scholar
  • 28 Ginat DT, Dhillon G, Almast J. Magnetic resonance imaging of neurosarcoidosis. J Clin Imaging Sci 2011; 1: 15
    PubMedGoogle Scholar
  • 29 Miller DH, Kendall BE, Barter S. , et al. Magnetic resonance imaging in central nervous system sarcoidosis. Neurology 1988; 38 (03) 378-383
    CrossrefPubMedGoogle Scholar
  • 30 Smith AS, Meisler DM, Weinstein MA. , et al. High-signal periventricular lesions in patients with sarcoidosis: neurosarcoidosis or multiple sclerosis?. AJR Am J Roentgenol 1989; 153 (01) 147-152
    CrossrefPubMedGoogle Scholar
  • 31 Scott TF. Neurosarcoidosis: progress and clinical aspects. Neurology 1993; 43 (01) 8-12
    CrossrefPubMedGoogle Scholar
  • 32 Cohen-Aubart F, Galanaud D, Grabli D. , et al. Spinal cord sarcoidosis: clinical and laboratory profile and outcome of 31 patients in a case-control study. Medicine (Baltimore) 2010; 89 (02) 133-140
    CrossrefPubMedGoogle Scholar
  • 33 Durel CA, Marignier R, Maucort-Boulch D. , et al. Clinical features and prognostic factors of spinal cord sarcoidosis: a multicenter observational study of 20 BIOPSY-PROVEN patients. J Neurol 2016; 263 (05) 981-990
    CrossrefPubMedGoogle Scholar
  • 34 Flanagan EP, Kaufmann TJ, Krecke KN. , et al. Discriminating long myelitis of neuromyelitis optica from sarcoidosis. Ann Neurol 2016; 79 (03) 437-447
    CrossrefPubMedGoogle Scholar
  • 35 Sohn M, Culver DA, Judson MA, Scott TF, Tavee J, Nozaki K. Spinal cord neurosarcoidosis. Am J Med Sci 2014; 347 (03) 195-198
    CrossrefPubMedGoogle Scholar
  • 36 Junger SS, Stern BJ, Levine SR, Sipos E, Marti-Masso JF. Intramedullary spinal sarcoidosis: clinical and magnetic resonance imaging characteristics. Neurology 1993; 43 (02) 333-337
    CrossrefPubMedGoogle Scholar
  • 37 Tavee JO, Stern BJ. Neurosarcoidosis. Clin Chest Med 2015; 36 (04) 643-656
    PubMedGoogle Scholar
  • 38 Varrassi M, Gianneramo C, Arrigoni F. , et al. Neurological involvement of IgG4-related disease: description of a case and review of the literature. Neuroradiol J 2017; 1971400917698173
    PubMedGoogle Scholar
  • 39 Said G, Lacroix C, Planté-Bordeneuve V. , et al. Nerve granulomas and vasculitis in sarcoid peripheral neuropathy: a clinicopathological study of 11 patients. Brain 2002; 125 (Pt 2): 264-275
    CrossrefPubMedGoogle Scholar
  • 40 Burns TM, Dyck PJ, Aksamit AJ, Dyck PJ. The natural history and long-term outcome of 57 limb sarcoidosis neuropathy cases. J Neurol Sci 2006; 244 (1-2): 77-87
    CrossrefPubMedGoogle Scholar
  • 41 Vital A, Lagueny A, Ferrer X, Louiset P, Canron MH, Vital C. Sarcoid neuropathy: clinico-pathological study of 4 new cases and review of the literature. Clin Neuropathol 2008; 27 (02) 96-105
    CrossrefPubMedGoogle Scholar
  • 42 Singhal NS, Irodenko VS, Margeta M, Layzer RB. Sarcoid polyneuropathy masquerading as chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2015; 52 (04) 664-668
    CrossrefPubMedGoogle Scholar
  • 43 Shah JR, Lewis RA. Sarcoidosis of the cauda equina mimicking Guillain-Barré syndrome. J Neurol Sci 2003; 208 (1-2): 113-117
    CrossrefPubMedGoogle Scholar
  • 44 Mattiassich G, Schubert H, Hutarew G, Wechselberger G. A rare manifestation of sarcoidosis with sensomotoric neuropathy of the ulnar nerve as the only symptom. BMJ Case Rep 2012; 2012: pii : bcr2012007430
    PubMedGoogle Scholar
  • 45 Verdú E, Ceballos D, Vilches JJ, Navarro X. Influence of aging on peripheral nerve function and regeneration. J Peripher Nerv Syst 2000; 5 (04) 191-208
    CrossrefPubMedGoogle Scholar
  • 46 Seddon HJ, Medawar PB, Smith H. Rate of regeneration of peripheral nerves in man. J Physiol 1943; 102 (02) 191-215
    CrossrefPubMedGoogle Scholar
  • 47 Bakkers M, Merkies IS, Lauria G. , et al. Intraepidermal nerve fiber density and its application in sarcoidosis. Neurology 2009; 73 (14) 1142-1148
    CrossrefPubMedGoogle Scholar
  • 48 Tavee JO, Karwa K, Ahmed Z, Thompson N, Parambil J, Culver DA. Sarcoidosis-associated small fiber neuropathy in a large cohort: clinical aspects and response to IVIG and anti-TNF alpha treatment. Respir Med 2017; 126: 135-138
    CrossrefPubMedGoogle Scholar
  • 49 Tavee J, Culver D. Sarcoidosis and small-fiber neuropathy. Curr Pain Headache Rep 2011; 15 (03) 201-206
    CrossrefPubMedGoogle Scholar
  • 50 Chen X, Graham J, Dabbah MA. , et al. Small nerve fiber quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fiber density. Diabetes Care 2015; 38: 1138-1144
    CrossrefPubMedGoogle Scholar
  • 51 Culver DA, Dahan A, Bajorunas D. , et al. Cibinetide improves corneal nerve fiber abundance in patients with sarcoidosis-associated small nerve fiber loss and neuropathic pain. Invest Ophthalmol Vis Sci 2017; 58 (06) BIO52-BIO60
    CrossrefPubMedGoogle Scholar
  • 52 Bomprezzi R, Pati S, Chansakul C, Vollmer T. A case of neurosarcoidosis successfully treated with rituximab. Neurology 2010; 75 (06) 568-570
    CrossrefPubMedGoogle Scholar
  • 53 Sherman JL, Stern BJ. Sarcoidosis of the CNS: comparison of unenhanced and enhanced MR images. AJR Am J Roentgenol 1990; 155 (06) 1293-1301
    CrossrefPubMedGoogle Scholar
  • 54 Culver DA. Diagnosing sarcoidosis. Curr Opin Pulm Med 2015; 21 (05) 499-509
    PubMedGoogle Scholar
  • 55 Judson MA, Costabel U, Drent M. , et al. The WASOG sarcoidosis organ assessment instrument: an update of a previous clinical tool. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31 (01) 19-27
    PubMedGoogle Scholar
  • 56 Kingah P, Alam M, Chugh K, Kamholz J, Samavati L. Role of pulmonary evaluation in diagnosis of neurosarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2016; 33 (03) 209-215
    PubMedGoogle Scholar
  • 57 Teirstein AS, Machac J, Almeida O, Lu P, Padilla ML, Iannuzzi MC. Results of 188 whole-body fluorodeoxyglucose positron emission tomography scans in 137 patients with sarcoidosis. Chest 2007; 132 (06) 1949-1953
    CrossrefPubMedGoogle Scholar
  • 58 Schelenz S, Barnes RA, Barton RC. , et al; British Society for Medical Mycology. British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases. Lancet Infect Dis 2015; 15 (04) 461-474
    CrossrefPubMedGoogle Scholar
  • 59 Williams WJ. The identification of sarcoid granulomas in the nervous system. Proc R Soc Med 1967; 60 (11, Part 1): 1170-1172
    PubMedGoogle Scholar
  • 60 Manz HJ. Pathobiology of neurosarcoidosis and clinicopathologic correlation. Can J Neurol Sci 1983; 10 (01) 50-55
    CrossrefPubMedGoogle Scholar
  • 61 Williams III DW, Elster AD, Kramer SI. Neurosarcoidosis: gadolinium-enhanced MR imaging. J Comput Assist Tomogr 1990; 14 (05) 704-707
    CrossrefPubMedGoogle Scholar
  • 62 Mirfakhraee M, Crofford MJ, Guinto Jr FC, Nauta HJ, Weedn VW. Virchow-Robin space: a path of spread in neurosarcoidosis. Radiology 1986; 158 (03) 715-720
    CrossrefPubMedGoogle Scholar
  • 63 Dumas JL, Valeyre D, Chapelon-Abric C. , et al. Central nervous system sarcoidosis: follow-up at MR imaging during steroid therapy. Radiology 2000; 214 (02) 411-420
    CrossrefPubMedGoogle Scholar
  • 64 Lexa FJ, Grossman RI. MR of sarcoidosis in the head and spine: spectrum of manifestations and radiographic response to steroid therapy. AJNR Am J Neuroradiol 1994; 15 (05) 973-982
    PubMedGoogle Scholar
  • 65 Wengert O, Rothenfusser-Korber E, Vollrath B. , et al. Neurosarcoidosis: correlation of cerebrospinal fluid findings with diffuse leptomeningeal gadolinium enhancement on MRI and clinical disease activity. J Neurol Sci 2013; 335 (1-2): 124-130
    CrossrefPubMedGoogle Scholar
  • 66 Lower EE, Weiss KL. Neurosarcoidosis. Clin Chest Med 2008; 29 (03) 475-492 , ix
    CrossrefPubMedGoogle Scholar
  • 67 Jurado R, Walker HK. Cerebrospinal fluid. In: Walker HK, Hall WD, Hurst JW. , eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston, MA: Butterworths; 1990
    Google Scholar
  • 68 Komori M, Blake A, Greenwood M. , et al. Cerebrospinal fluid markers reveal intrathecal inflammation in progressive multiple sclerosis. Ann Neurol 2015; 78 (01) 3-20
    CrossrefPubMedGoogle Scholar
  • 69 Reske D, Petereit HF, Heiss WD. Difficulties in the differentiation of chronic inflammatory diseases of the central nervous system--value of cerebrospinal fluid analysis and immunological abnormalities in the diagnosis. Acta Neurol Scand 2005; 112 (04) 207-213
    CrossrefPubMedGoogle Scholar
  • 70 Bridel C, Courvoisier DS, Vuilleumier N, Lalive PH. Cerebrospinal fluid angiotensin-converting enzyme for diagnosis of neurosarcoidosis. J Neuroimmunol 2015; 285: 1-3
    CrossrefPubMedGoogle Scholar
  • 71 Khoury J, Wellik KE, Demaerschalk BM, Wingerchuk DM. Cerebrospinal fluid angiotensin-converting enzyme for diagnosis of central nervous system sarcoidosis. Neurologist 2009; 15 (02) 108-111
    CrossrefPubMedGoogle Scholar
  • 72 Petereit HF, Reske D, Tumani H. , et al. Soluble CSF interleukin 2 receptor as indicator of neurosarcoidosis. J Neurol 2010; 257 (11) 1855-1863
    CrossrefPubMedGoogle Scholar
  • 73 Chalon MP, Sindic CJ, Laterre EC. Serum and CSF levels of soluble interleukin-2 receptors in MS and other neurological diseases: a reappraisal. Acta Neurol Scand 1993; 87 (02) 77-82
    PubMedGoogle Scholar
  • 74 Dyck PJ, Albers JW, Wolfe J. , et al; Clinical vs. Neurophysiology Trial 3 Investigators. A trial of proficiency of nerve conduction: greater standardization still needed. Muscle Nerve 2013; 48 (03) 369-374
    CrossrefPubMedGoogle Scholar
  • 75 Yamakawa KS, Haig AJ, Geisser ME, Tong HC, Chiodo A, Miner JA. The clinician effect on “objective” technical components of the electrodiagnostic consultation. Am J Phys Med Rehabil 2007; 86 (05) 364-372
    CrossrefPubMedGoogle Scholar
  • 76 Dillingham T, Chen S, Andary M. , et al. Establishing high-quality reference values for nerve conduction studies: a report from the normative data task force of the American Association Of Neuromuscular & Electrodiagnostic Medicine. Muscle Nerve 2016; 54 (03) 366-370
    CrossrefPubMedGoogle Scholar
  • 77 Neville E, Walker AN, James DG. Prognostic factors predicting the outcome of sarcoidosis: an analysis of 818 patients. Q J Med 1983; 52 (208) 525-533
    PubMedGoogle Scholar
  • 78 Luke RA, Stern BJ, Krumholz A, Johns CJ. Neurosarcoidosis: the long-term clinical course. Neurology 1987; 37 (03) 461-463
    CrossrefPubMedGoogle Scholar
  • 79 Huang CT, Heurich AE, Sutton AL, Lyons HA. Mortality in sarcoidosis. A changing pattern of the causes of death. Eur J Respir Dis 1981; 62 (04) 231-238
    PubMedGoogle Scholar
  • 80 Judson MA, Boan AD, Lackland DT. The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States. Sarcoidosis Vasc Diffuse Lung Dis 2012; 29 (02) 119-127
    PubMedGoogle Scholar
  • 81 Scott TF, Yandora K, Valeri A, Chieffe C, Schramke C. Aggressive therapy for neurosarcoidosis: long-term follow-up of 48 treated patients. Arch Neurol 2007; 64 (05) 691-696
    CrossrefPubMedGoogle Scholar
  • 82 Sharma OP. Effectiveness of chloroquine and hydroxychloroquine in treating selected patients with sarcoidosis with neurological involvement. Arch Neurol 1998; 55 (09) 1248-1254
    CrossrefPubMedGoogle Scholar
  • 83 Wijsenbeek MS, Culver DA. Treatment of sarcoidosis. Clin Chest Med 2015; 36 (04) 751-767
    PubMedGoogle Scholar
  • 84 Lacomis D. Neurosarcoidosis. Curr Neuropharmacol 2011; 9 (03) 429-436
    CrossrefPubMedGoogle Scholar
  • 85 Teirstein A. Neuromuscular sarcoidosis. Semin Respir Crit Care Med 2002; 23 (06) 505-512
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 86 Nozaki K, Judson MA. Neurosarcoidosis. Curr Treat Options Neurol 2013; 15 (04) 492-504
    CrossrefPubMedGoogle Scholar
  • 87 Foundation for Sarcoidosis Research. Sarcoidosis treatment guidelines. 2013. Available at: http://do.ready-for-feedback.com/glc/fsr/wp-content/uploads/Treatment-Protocol.pdf . Accessed April 18, 2017
    PubMedGoogle Scholar
  • 88 Agbogu BN, Stern BJ, Sewell C, Yang G. Therapeutic considerations in patients with refractory neurosarcoidosis. Arch Neurol 1995; 52 (09) 875-879
    CrossrefPubMedGoogle Scholar
  • 89 Sahoo DH, Bandyopadhyay D, Xu M. , et al. Effectiveness and safety of leflunomide for pulmonary and extrapulmonary sarcoidosis. Eur Respir J 2011; 38 (05) 1145-1150
    CrossrefPubMedGoogle Scholar
  • 90 Bitoun S, Bouvry D, Borie R. , et al. Treatment of neurosarcoidosis: a comparative study of methotrexate and mycophenolate mofetil. Neurology 2016; 87 (24) 2517-2521
    CrossrefPubMedGoogle Scholar
  • 91 Androdias G, Maillet D, Marignier R. , et al. Mycophenolate mofetil may be effective in CNS sarcoidosis but not in sarcoid myopathy. Neurology 2011; 76 (13) 1168-1172
    CrossrefPubMedGoogle Scholar
  • 92 Metyas S, Tawadrous M, Yeter KC, Arkfeld DG. Neurosarcoidosis mimicking multiple sclerosis successfully treated with methotrexate and adalimumab. Int J Rheum Dis 2014; 17 (02) 214-216
    CrossrefPubMedGoogle Scholar
  • 93 Cohen Aubart F, Bouvry D, Galanaud D. , et al. Long-term outcomes of refractory neurosarcoidosis treated with infliximab. J Neurol 2017; 264 (05) 891-897
    CrossrefPubMedGoogle Scholar
  • 94 Marnane M, Lynch T, Scott J, Stack J, Kelly PJ. Steroid-unresponsive neurosarcoidosis successfully treated with adalimumab. J Neurol 2009; 256 (01) 139-140
    CrossrefPubMedGoogle Scholar
  • 95 Lorentzen AO, Sveberg L, Midtvedt Ø, Kerty E, Heuser K. Overnight response to infliximab in neurosarcoidosis: a case report and review of infliximab treatment practice. Clin Neuropharmacol 2014; 37 (05) 142-148
    CrossrefPubMedGoogle Scholar
  • 96 Moravan M, Segal BM. Treatment of CNS sarcoidosis with infliximab and mycophenolate mofetil. Neurology 2009; 72 (04) 337-340
    CrossrefPubMedGoogle Scholar
  • 97 Drent M, Cremers JP, Jansen TL, Baughman RP. Practical eminence and experience-based recommendations for use of TNF-α inhibitors in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31 (02) 91-107
    PubMedGoogle Scholar
  • 98 Sodhi M, Pearson K, White ES, Culver DA. Infliximab therapy rescues cyclophosphamide failure in severe central nervous system sarcoidosis. Respir Med 2009; 103 (02) 268-273
    CrossrefPubMedGoogle Scholar
  • 99 Panselinas E, Rodgers JK, Judson MA. Clinical outcomes in sarcoidosis after cessation of infliximab treatment. Respirology 2009; 14 (04) 522-528
    CrossrefPubMedGoogle Scholar
  • 100 Gisbert JP, Panés J. Loss of response and requirement of infliximab dose intensification in Crohn's disease: a review. Am J Gastroenterol 2009; 104 (03) 760-767
    CrossrefPubMedGoogle Scholar
  • 101 Doty JD, Mazur JE, Judson MA. Treatment of corticosteroid-resistant neurosarcoidosis with a short-course cyclophosphamide regimen. Chest 2003; 124 (05) 2023-2026
    CrossrefPubMedGoogle Scholar
  • 102 Travis LB, Curtis RE, Glimelius B. , et al. Bladder and kidney cancer following cyclophosphamide therapy for non-Hodgkin's lymphoma. J Natl Cancer Inst 1995; 87 (07) 524-530
    CrossrefPubMedGoogle Scholar
  • 103 Baker GL, Kahl LE, Zee BC, Stolzer BL, Agarwal AK, Medsger Jr TA. Malignancy following treatment of rheumatoid arthritis with cyclophosphamide. Long-term case-control follow-up study. Am J Med 1987; 83 (01) 1-9
    PubMedGoogle Scholar
  • 104 Catania A, Lonati C, Sordi A, Carlin A, Leonardi P, Gatti S. The melanocortin system in control of inflammation. Sci World J 2010; 10: 1840-1853
    CrossrefPubMedGoogle Scholar
  • 105 Berkovich R, Agius MA. Mechanisms of action of ACTH in the management of relapsing forms of multiple sclerosis. Ther Adv Neurol Disorder 2014; 7 (02) 83-96
    PubMedGoogle Scholar
  • 106 Tao YX. The melanocortin-4 receptor: physiology, pharmacology, and pathophysiology. Endocr Rev 2010; 31 (04) 506-543
    CrossrefPubMedGoogle Scholar
  • 107 Baughman RP, Barney JB, O'Hare L, Lower EE. A retrospective pilot study examining the use of Acthar gel in sarcoidosis patients. Respir Med 2016; 110: 66-72
    CrossrefPubMedGoogle Scholar
  • 108 Avivi I, Stroopinsky D, Katz T. Anti-CD20 monoclonal antibodies: beyond B-cells. Blood Rev 2013; 27 (05) 217-223
    CrossrefPubMedGoogle Scholar
  • 109 Lunde S, Kristoffersen EK, Sapkota D. , et al. Serum BAFF and APRIL levels, T-lymphocyte subsets, and immunoglobulins after B-cell depletion using the monoclonal anti-CD20 antibody rituximab in myalgic encephalopathy/chronic fatigue syndrome. PLoS One 2016; 11 (08) e0161226
    CrossrefPubMedGoogle Scholar
  • 110 Sawaya R, Radwan W. Sarcoidosis associated with neuromyelitis optica. J Clin Neurosci 2013; 20 (08) 1156-1158
    CrossrefPubMedGoogle Scholar
  • 111 Menninger MD, Amdur RJ, Marcus Jr RB. Role of radiotherapy in the treatment of neurosarcoidosis. Am J Clin Oncol 2003; 26 (04) e115-e118
    PubMedGoogle Scholar
  • 112 Kang S, Suh JH. Radiation therapy for neurosarcoidosis: report of three cases from a single institution. Radiat Oncol Investig 1999; 7 (05) 309-312
    CrossrefPubMedGoogle Scholar