[Subacute myelopathy revealing systemic sarcoidosis].
BACKGROUND
The spinal localization is rare for neurosarcoidosis (0.43 percent of cases) but can be the inaugural manifestation of the disease. We report two cases of spinal neurosarcoidosis in a 57-year-old man and a 43-year*old woman with uneventful past medical histories. Both presented progressive myelopathic features.


METHODS
Magnetic resonance imaging (MRI) of the spine demonstrated intramedullary lesions, dorsal in the first case, and cervical in the second case. Serum angiotensin converting enzyme was elevated. Radiographs of the chest revealed bilateral symmetric hilar mediastinal lymphadenopathy in the first patient, and bronchial biopsy demonstrated non caseating granulomas. In the second patient the diagnosis was made on pathological examination of a minor salivary gland biopsy.


RESULTS
The patients received corticosteroid therapy with good response in the second patient.


CONCLUSIONS
The diagnosis of intramedullary sarcoidosis is difficult without a previous diagnosis of systemic sarcoidosis or other apparent symptom(s). Extraneurologic biopsies may be suggestive. We reviewed the literature on the diagnosis and treatment of intramedullary sarcoidosis.
Boulaajaj
F Z
FZ
Service de Neurologie--Explorations Fonctionnelles, CHU Ibn Rochd, Quartier des Hôpitaux, Casablanca, Maroc. mo.mi2@caramail.com
Rafai
M A
MA
El Otmani
H
H
El Moutawakkil
B
B
Hakim
K
K
Fadel
H
H
Slassi
I
I
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D006099:Granuloma / Q000150:complications / Q000473:pathology; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008477:Mediastinal Diseases / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D011859:Radiography; D012469:Salivary Glands / Q000473:pathology; D012507:Sarcoidosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D013118:Spinal Cord Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D013131:Spine / Q000473:pathology
D000893:Anti-Inflammatory Agents; D007703:Peptidyl-Dipeptidase A