Isolated neurosarcoidosis presenting as headache and multiple brain and spinal cord lesions mimicking central nervous system metastases.
Sarcoidosis is uncommon in children. Although isolated neurosarcoidosis has been seen in 15% adults with sarcoidosis, pediatric neurosarcoidosis is rarely reported. Neurosarcoidosis may present with cranial neuropathy, including facial palsy, optic nerve or other cranial nerve involvement, peripheral neuropathy, or manifestations of the central nervous system affecting the hypothalamus, pituitary gland, cerebral cortex, cerebellum, meninges, and spinal cord. The useful diagnostic investigations include magnetic resonance imaging of the brain and spinal cord, cerebrospinal fluid studies, brain and meningeal biopsy if feasible, chest radiography to reveal sarcoidosis, angiotensin-converting enzyme level in the serum or cerebrospinal fluid, and Kveim test when available. We herein report a case of isolated brain biopsy-confirmed neurosarcoidosis in a 17-year-old boy presenting with severe unilateral headache and multiple brain and spinal cord MRI lesions mimicking central nervous system metastases.
Tsao
Chang-Yong
CY
Department of Pediatrics and Neurology, The Ohio State University, OH, USA. ctsao@chi.osu.edu
Lo
Warren D
WD
Rusin
Jerome A
JA
Henwood
Maria J
MJ
Boue
Daniel R
DR
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D002493:Central Nervous System Diseases / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D016543:Central Nervous System Neoplasms / Q000473:pathology*; D020790:Diabetes Insipidus, Neurogenic / Q000209:etiology; D003937:Diagnosis, Differential; D006261:Headache / Q000209:etiology*; D006801:Humans; D007006:Hypogonadism / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D012507:Sarcoidosis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D013116:Spinal Cord / Q000473:pathology*
D000893:Anti-Inflammatory Agents; D011241:Prednisone