A challenging case: spinal cord sarcoidosis

A 54-year old man with severe ankylosing spondylitis presented with rapidly progressing bilateral lower limb weakness and altered sensation, associated with urinary retention. Examination showed flaccid paraparesis with lower limb areflexia and a sensory level to T10. His upper limbs were normal. MR scan of whole spine showed marked ankylosing spondylitis changes, including canal narrowing, and extensive, discontinuous signal change within the spinal cord at C7–T1, T3–T4 and T7–T11. There was no leptomeningeal enhancement. Severe ankylosing spondylitis meant we were unable to obtain CSF, MR scan of head or do a leptomeningeal biopsy (anaesthetic risk). CT scan of thorax however showed extensive mediastinal and hilar lymphadenopathy. We could therefore obtain a tissue diagnosis from lymph node biopsy, which showed sarcoid-type, non-caseating granulomas. We diagnosed neurosarcoidosis and prescribed immunosuppression. His paraplegia is unchanged, but his neurology is stable. Spinal cord sarcoidosis is rare (
Source: Journal of Neurology, Neurosurgery and Psychiatry - Category: Neurosurgery Authors: Tags: Abstracts Source Type: research

Related Links:

Conclusion: This study is the largest to date analyzing the potential influence of neighborhood deprivation on ADs. Our results indicate that neighborhood deprivation may affect risk of ADs, independent of individual level sociodemographic characteristics. For health care policies, both individual and neighborhood level approaches seem to be of importance.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Purpose of review Sarcoidosis is an immune-mediated disease of unknown cause. Immune-mediated diseases appear to cluster in patients and in families. We review what is known on this topic for sarcoidosis, and what factors may underlie disease clustering. Recent findings In populations of patients with sarcoidosis, relative risk estimates of Sjögren's syndrome, systemic lupus erythematosus, autoimmune hepatitis, ankylosing spondylitis, multiple sclerosis (MS), celiac disease, autoimmune thyroid disease, and ulcerative colitis, varied between 2.1 and 11.6. In relatives of patients with sarcoidosis, relative risk es...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research
Authors: Neiter E, Conart JB, Baumann C, Rousseau H, Zuily S, Angioi-Duprez K Abstract INTRODUCTION: The purpose of this study was to describe the epidemiologic characteristics of adult uveitis evaluated at the regional center of excellence specializing in systemic and autoimmune disease in the Nancy university medical center. The secondary objectives were to describe the progression over time of the various etiologies and to identify local specificities. MATERIALS AND METHODS: We performed a retrospective epidemiological study of patients diagnosed with uveitis. All patients were referred to the regional cente...
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
AbstractThere are no universally accepted diagnostic criteria for large-vessel vasculitides (LVV), including giant cell arteritis (GCA) and Takayasu arteritis (TAK). Currently, available classification criteria cannot be used for the diagnosis of GCA and TAK. Early diagnosis of these two diseases is quite challenging in clinical practice and may be accomplished only by combining the patient symptoms, physical examination findings, blood test results, imaging findings, and biopsy results, if available. Awareness of red flags which lead the clinician to investigate TAK in a young patient with persistent systemic inflammation...
Source: Rheumatology International - Category: Rheumatology Source Type: research
CONCLUSIONS In a single ophthalmic center in Poland, and throughout Europe, the causes of uveitis are varied. Genetic, geographic, social and environmental factors are likely to affect the cause of uveitis in different populations. PMID: 30504763 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
We report a case of acute nongranulomatous tubulointerstitial nephritis in an HLA-B27-positive patient with axial spondyloarthritis and Crohn's disease being treated with adalimumab.ResumenLos antagonistas del factor de necrosis tumoral-alfa (ATNF) se utilizan en el tratamiento de múltiples enfermedades, como artritis psoriásica, enfermedad de Crohn, espondilitis anquilosante, artritis idiopática juvenil, generalmente, cuando son refractarias al tratamiento de primera línea.1 La utilización de los ATNF se ha asociado con la inducción de enfermedades autoinmunes, como lupus eritemat...
Source: Reumatologia Clinica - Category: Rheumatology Source Type: research
Purpose of review Sarcoidosis is a rare, multisystem granulomatous disease of incompletely understood pathogenesis. Clinically, it shares common features with several systemic and organ-specific autoimmune diseases, although known autoantibodies or useful serologic markers for diagnosis and monitoring of disease activity are lacking. Sarcoidosis can both coexist with or mimic connective tissue diseases or vasculitis. Here, we review possible common etiologic factors between sarcoidosis and autoimmune disease, comparing clinical, laboratory and imaging features. Recent findings Autoimmune diseases may precede or follow...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Peter Korsten and Marjolein Drent Source Type: research
We present one of the first cases of M. marinum infection associated with infliximab therapy in a patient with pulmonary and skin sarcoidosis.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Publication date: Available online 19 May 2018Source: Joint Bone SpineAuthor(s): Daniel Wendling, Jean-Philippe Nueffer
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
Abstract Intraocular inflammation with the imprecise and broad umbrella term "uveitis" is a diagnostic and therapeutic challenge in ophthalmology. Uveitis is one of the most common causes of blindness worldwide and due to the associated costs is comparable to diabetic retinopathy. Patients can be affected by uveitis at any age. Any part of the eye may be affected. The symptoms range from complete absence of symptoms, through all types of vision deterioration up to a red and even very painful eye. Uveitis can be strictly unilateral (also alternating from the left to the right eye) or bilateral w...
Source: Zeitschrift fur Rheumatologie - Category: Rheumatology Authors: Tags: Z Rheumatol Source Type: research
More News: Anesthesia | Anesthesiology | Ankylosing Spondylitis | Brain | CT Scan | Neurology | Neurosurgery | PET Scan | Psychiatry | Sarcoidosis