[Bilateral optic neuropathy revealing systemic sarcoidosis].
BACKGROUND
Although ocular involvement concerns about 25 to 60% of patients with systemic sarcoidosis, papilledema is a rare event.


METHODS
A 43-year-old man presented with left visual loss related to papillitis. Despite high-dose corticosteroids, visual loss became rapidly bilateral. Thoracic CT-scan showed mediastinal and parenchymal involvement. Histological study of lung, bronchial and lymphadenopathy biopsies displayed giant-cells granuloma without necrosis. Diagnosis of sarcoidosis complicated with optic neuropathy was made. Therapy combining prednisone, methotrexate and infliximab was started without significant improvement of visual acuity.


CONCLUSIONS
This report underlines the potential severity of optic neuropathy in sarcoidosis.
Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France. pguilpain@wanadoo.fr
P
P
Guilpain
M A
MA
Andreu
N
N
Cassoux
D
D
Le Thi Huong-Boutin
F
F
Jaeger-Bizet
X
X
Nasica
C
C
Chapelon-Abric
B
B
Wechsler
P
P
Lehoang
J C
JC
Piette
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D009896:Optic Atrophy / Q000175:diagnosis / Q000209:etiology; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology*; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D000069285:Infliximab; D011241:Prednisone; D008727:Methotrexate