title: [Case of sarcoidosis with myelodysplastic syndrome in an elderly woman].
abstract: An 85-year-old woman, who had been given a diagnosis of myelodysplastic syndrome with refractory anemia 2 years previously and required blood transfusion once a month, was admitted with complaints of fever, general fatigue, and dry cough. A chest X-ray film showed multiple small nodules in bilateral lung fields which were not observed 1 month previously. Although smear and culture tests for acid-fast bacilli in her bronchoalveolar lavage fluid, urine, and bone marrow aspiration fluid were all negative, miliary tuberculosis was strongly suspected. Antituberculosis drugs were administered, but neither her symptoms nor chest X-ray findings improved. Five months later, right oculomotor nerve palsy, followed by left abducens nerve paralysis occurred. Lumber puncture examination revealed lymphocytosis, and increased protein and ACE levels, suggesting neurosarcoidosis. A transbronchial lung biopsy specimen demonstrated non-caseating epithelioid granulomas. Oral administration of 30 mg/day prednisolone improved her symptoms as well as the chest X-ray findings.
authors.affiliation: Department of Respiratory Medicine, Kanto Central Hospital.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Horie
authors.forename: Satoshi
authors.initials: S
authors.lastname: Noguchi
authors.forename: Wakae
authors.initials: W
authors.lastname: Tanaka
authors.forename: Hisanao
authors.initials: H
authors.lastname: Yoshihara
authors.forename: Masaki
authors.initials: M
authors.lastname: Kawakami
authors.forename: Masaru
authors.initials: M
authors.lastname: Suzuki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Teruaki
authors.initials: T
authors.lastname: Oka
mesh_terms: D000284:Administration, Oral; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000150:complications*; D011239:Prednisolone / Q000008:administration & dosage; D012507:Sarcoidosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone