Imran Tasnim F, Nizami Sobia, Eyzner Igor, Mirani Neena, Hossain Tanzib, Fede Robert, Capitle Eugenio
Department of Medicine, New Jersey Medical School Rutgers, The State University of New Jersey, 185 South Orange Avenue, Newark, NJ 07103, USA.
Department of Pathology and Laboratory Medicine, New Jersey Medical School Rutgers, The State University of New Jersey, 185 South Orange Avenue, Newark, NJ 07103, USA.
Case Rep Med. 2015;2015:397046. doi: 10.1155/2015/397046. Epub 2015 Apr 2.
Sarcoidosis is a granulomatous disease of unknown etiology that affects multiple organ systems. Neurological manifestations of sarcoidosis are less common and can include cranial neuropathies and intracranial lesions. We report the case of a 21-year-old man who presented with vertigo and uveitis. Extensive workup including brain imaging revealed enhancing focal lesions. A lacrimal gland biopsy confirmed the diagnosis of sarcoidosis. The patient was initially treated with prednisone, which did not adequately control his symptoms, and then was switched to methotrexate with moderate symptomatic improvement. Our patient had an atypical presentation with vertigo as the predominant manifestation of sarcoidosis. Patients with neurosarcoidosis typically present with systemic involvement of sarcoidosis followed by neurologic involvement. Vertigo is rarely reported as an initial manifestation. This case highlights the importance of consideration of neurosarcoidosis as an entity even in patients that may not have a typical presentation or systemic involvement of disease.
结节病是一种病因不明的肉芽肿性疾病，可累及多个器官系统。结节病的神经表现较为少见，可包括颅神经病变和颅内病变。我们报告一例21岁男性患者，其表现为眩晕和葡萄膜炎。包括脑部影像学检查在内的全面检查发现有强化的局灶性病变。泪腺活检确诊为结节病。患者最初接受泼尼松治疗，但症状控制不佳，随后改用甲氨蝶呤，症状有中度改善。我们的患者表现不典型，以眩晕为结节病的主要表现。神经结节病患者通常先出现结节病的全身受累，随后出现神经受累。眩晕很少作为初始表现被报道。该病例强调，即使在可能没有典型表现或疾病全身受累的患者中，也应考虑神经结节病这一疾病实体。
