Recurrence of sarcoidosis after lung transplantation presenting as neurosarcoidosis

2020 ◽  
pp. 10.1212/CPJ.0000000000000980
Author(s):  
Robert Case ◽  
Ramon Valentin ◽  
Aaron Carlson ◽  
Diana Gomez ◽  
Hassan Alnauimat ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Clinical Presentation ◽  
Subsequent Development ◽  
Pulmonary Sarcoidosis ◽  
Steroid Treatment ◽  
Acute Encephalopathy ◽  
Mri Imaging ◽  
Mri Findings ◽  
Treatment Support ◽  
Is Development

Recurrence of pulmonary sarcoidosis after transplantation of the lung is known to occur and has not been shown to lead to negative outcomes. However, recurrence in a new primary organ is incredibly rare and not an established pattern of clinical presentation. Neurosarcoidosis can present in a variety of ways, one of which is development of acute encephalopathy and diffuse leptomeningeal enhancement on MRI imaging. In the case we present, the MRI findings, the improvement of symptoms and imaging abnormalities with steroid treatment support a diagnosis of probable neurosarcoidosis. Since a minority of patients who undergo lung transplantation have sarcoidosis, it is possible that subsequent development of neurosarcoidosis may be under recognized.

Neurosarcoidosis Presenting as Schizophreniform Disorder

1992 ◽  
Vol 22 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Mohamed Sabaawi ◽  
Jose Gutierrez-Nunez ◽  
M. Richard Fragala
Keyword(s):  
Cognitive Decline ◽  
Mental Status ◽  
Clinical Presentation ◽  
Psychiatric Symptoms ◽  
Steroid Treatment ◽  
Schizophreniform Disorder ◽  
Schizophrenic Psychosis ◽  
Neurologic Involvement ◽  
Mental Status Examination ◽  
Psychiatric Manifestations

A patient whose clinical presentation met criteria for schizophreniform disorder was ultimately found to have neurosarcoidosis, and the psychiatric symptoms responded to steroid treatment. The ongoing search for organic etiology was prompted by the presence of cognitive decline, perseveration and rare bizarre automatisms. This is virtually the first reported association between schizophreniform disorder and sarcoidosis. We reviewed the literature on neurologic involvement and psychiatric manifestations in sarcoidosis as well as the concurrence between organicity and schizophrenic psychosis. The importance of attending to all elements of the mental status examination in a patient with complex atypical findings is underscored.

Potential use of biomarkers for the clinical evaluation of sarcoidosis

2021 ◽  
pp. jim-2020-001659
Author(s):  
Amir Mousapasandi ◽  
Cristan Herbert ◽  
Paul Thomas
Keyword(s):  
Clinical Evaluation ◽  
Clinical Presentation ◽  
Current Knowledge ◽  
Epithelioid Cell ◽  
Pulmonary Sarcoidosis ◽  
Biological Molecules ◽  
Unknown Etiology ◽  
Chronic Antigenic Stimulation ◽  
Host Genetic ◽  
Potential Use

Sarcoidosis is a systemic granulomatous disease of unknown etiology and pathogenesis with a heterogeneous clinical presentation. In the appropriate clinical and radiological context and with the exclusion of other diagnoses, the disease is characterized by the pathological presence of non-caseating epithelioid cell granulomas. Sarcoidosis is postulated to be a multifactorial disease caused by chronic antigenic stimulation. The immunopathogenesis of sarcoidosis encompasses a complex interaction between the host, genetic factors and postulated environmental and infectious triggers, which result in granuloma development.The exact pathogenesis of the disease has yet to be elucidated, but some of the inflammatory pathways that play a key role in disease progression and outcomes are becoming apparent, and these may form the logical basis for selecting potential biomarkers.Biomarkers are biological molecules that are altered pathologically. To date, there exists no single reliable biomarker for the evaluation of sarcoidosis, either diagnostically or prognostically but new candidates are emerging. A diagnosis of sarcoidosis ideally requires a biopsy confirming non-caseating granulomas, but the likelihood of progression that requires intervention remains unpredictable. These challenging aspects could be potentially resolved by incorporating biomarkers into clinical practice for both diagnosis and monitoring disease activity.This review outlines the current knowledge on sarcoidosis with an emphasis on pulmonary sarcoidosis, and delineates the understanding surrounding the implication of biomarkers for the clinical evaluation of sarcoidosis.

Clinical Presentation and Cranial MRI Findings of Listeria monocytogenes Encephalitis

2018 ◽  
Vol 23 (6) ◽  
pp. 198-203 ◽  
Author(s):  
Ferhat Arslan ◽  
Gülhan Ertan ◽  
Ahmet N. Emecen ◽  
Pierre Fillatre ◽  
Ali Mert ◽  
...  
Keyword(s):  
Listeria Monocytogenes ◽  
Clinical Presentation ◽  
Mri Findings ◽  
Cranial Mri

scholarly journals Cardiac Sarcoidosis as an Uncommon Etiology for Posterior Circulation Stroke Presenting with Alexia without Agraphia

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Mohankumar Kurukumbi ◽  
Lauren Gardiner ◽  
Shevani Sahai ◽  
John W. Cochran
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Cardiac Involvement ◽  
Clinical Presentation ◽  
Cardiac Sarcoidosis ◽  
Systemic Disease ◽  
Pulmonary Sarcoidosis ◽  
Posterior Circulation ◽  
Presenting Symptoms ◽  
Memory And Recall

Sarcoidosis is a systemic disease with cardiac involvement occurring in 20-50% of cases. Cardiogenic stroke caused by cardiac sarcoidosis, especially PCA infarction, is a rare clinical presentation that necessitates timely diagnosis and may warrant treatment prophylaxis against CVA. In this case report, we describe a 54-year-old Caucasian male presenting with left PCA stroke in the setting of cardiac and pulmonary sarcoidosis, and hypertension. His presenting symptoms included right partial hemianopia, difficulty with naming, memory, and recall, and alexia without agraphia. Cardiogenic stroke is an uncommon manifestation of cardiac sarcoidosis, and given the disabling nature of these sequelae, the importance of early diagnosis and prevention with anticoagulation is crucial to prevent morbidity and mortality.

Primary Graft Dysfunction

2021 ◽  
Vol 42 (03) ◽  
pp. 368-379
Author(s):  
Jake G. Natalini ◽  
Joshua M. Diamond
Keyword(s):  
Risk Factors ◽  
Lung Transplantation ◽  
Ex Vivo ◽  
Significant Risk ◽  
Subsequent Development ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Donor Pool ◽  
Ex Vivo Lung Perfusion ◽  
Increased Risk

AbstractPrimary graft dysfunction (PGD) is a form of acute lung injury after transplantation characterized by hypoxemia and the development of alveolar infiltrates on chest radiograph that occurs within 72 hours of reperfusion. PGD is among the most common early complications following lung transplantation and significantly contributes to increased short-term morbidity and mortality. In addition, severe PGD has been associated with higher 90-day and 1-year mortality rates compared with absent or less severe PGD and is a significant risk factor for the subsequent development of chronic lung allograft dysfunction. The International Society for Heart and Lung Transplantation released updated consensus guidelines in 2017, defining grade 3 PGD, the most severe form, by the presence of alveolar infiltrates and a ratio of PaO2:FiO2 less than 200. Multiple donor-related, recipient-related, and perioperative risk factors for PGD have been identified, many of which are potentially modifiable. Consistently identified risk factors include donor tobacco and alcohol use; increased recipient body mass index; recipient history of pulmonary hypertension, sarcoidosis, or pulmonary fibrosis; single lung transplantation; and use of cardiopulmonary bypass, among others. Several cellular pathways have been implicated in the pathogenesis of PGD, thus presenting several possible therapeutic targets for preventing and treating PGD. Notably, use of ex vivo lung perfusion (EVLP) has become more widespread and offers a potential platform to safely investigate novel PGD treatments while expanding the lung donor pool. Even in the presence of significantly prolonged ischemic times, EVLP has not been associated with an increased risk for PGD.

Thoracolumbar myelopathy with diffuse vertebral involvement in a dog secondary to aleukaemic lymphocytic leukaemia

2019 ◽  
Vol 7 (3) ◽  
pp. e000852
Author(s):  
Caitlin Elizabeth Doran ◽  
Simon Platt ◽  
Vivian Lau ◽  
Melinda Camus
Keyword(s):  
Clinical Presentation ◽  
Lymphocytic Leukaemia ◽  
Intrathecal Chemotherapy ◽  
High Rate ◽  
Neurological Involvement ◽  
Neurological Sequela ◽  
Mri Findings ◽  
Acute Lymphocytic Leukaemia ◽  
Clinical Presentations ◽  
Vertebral Involvement

Incidence rate of lymphocytic leukaemia is unknown in canine patients; neurological manifestations and imaging findings are rarely reported. In human medicine, acute lymphocytic leukaemia is known to have a high rate of meningeal metastasis prompting the use of intrathecal chemotherapy for newly diagnosed cases regardless of neurological signs. This report documents the clinical presentation and diagnostic findings in a dog presenting with paraparesis and pain, ultimately diagnosed with aleukaemic lymphocytic leukaemia. MRI findings with diffuse vertebral involvement secondary to lymphocytic leukaemia have not been documented in the veterinary literature. This report adds to the clinical presentations of leukaemia in canines and highlights a neurological sequela of the disease. Further investigation into neurological involvement of leukaemia is needed in veterinary medicine and necropsy, with meningeal histopathology, is recommended for all cases of acute lymphocytic leukaemia in canines to assess the metastatic rate and direct further research.

scholarly journals PATHOLOGY OF ALL ASPECTS OF END-STAGE PULMONARY SARCOIDOSIS: A RETROSPECTIVE ANALYSIS OF LUNG EXPLANTS FROM A HIGH-VOLUME LUNG TRANSPLANTATION CENTER

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A2489-A2490
Author(s):  
Matthew Zheng ◽  
Stephanie Tittaferrante ◽  
Andrew Gangemi ◽  
Catherine Myers ◽  
Francis Cordova ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Retrospective Analysis ◽  
High Volume ◽  
Pulmonary Sarcoidosis ◽  
Transplantation Center ◽  
End Stage

scholarly journals Unusual Presentation of a Colonic Sarcoidosis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Sami Daldoul ◽  
Wissem Triki ◽  
Kaouther El Jeri ◽  
Abdeljelil Zaouche
Keyword(s):  
Preoperative Diagnosis ◽  
Clinical Presentation ◽  
Giant Cells ◽  
Right Hemicolectomy ◽  
Pulmonary Sarcoidosis ◽  
The Body ◽  
Resected Specimen ◽  
Ascending Colon ◽  
Radiologic Findings ◽  
Rare Location

Sarcoidosis is a multisystemic disorder of unknown cause that affects almost every tissue in the body. Colon is an extremely rare location of this disease. Clinical presentation, endoscopic appearances, and radiologic findings are not specific and may mimic much other affection. We report the case of a 64-year-old woman with inactive pulmonary sarcoidosis who presented alternating constipation and diarrhea. Colonoscopy revealed a stenotic tumor in the ascending colon. Histology failed to determine the nature of the lesion. Radiologic findings are those of a long stenotic tumor of the ascending colon associated with a multiple satellite lymphadenopathy. Endoscopic and radiologic descriptions are highly suggestive of a malignancy. The patient underwent a laparotomy, and a right hemicolectomy was performed. Examination of the resected specimen showed follicular structure with central epitheloid and giant cells and surrounding fibroblasts. These findings made the diagnosis of colonic sarcoidosis. The nonspecificity of the endoscopic and radiological signs of gastrointestinal sarcoidosis and the extreme rarity of colonic location make the preoperative diagnosis unlikely. The diagnosis will be then made only on histological examination of surgical specimens. We describe, through this observation, the results of paraclinical investigations that can suggest diagnosis and perhaps avoid surgery.

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