Diagnosis of Neurosarcoidosis and Muscular Sarcoidosis
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Accession number;06A0484822
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| Title;Diagnosis of Neurosarcoidosis and Muscular Sarcoidosis |
| Author;
KUMAMOTO TOSHIHIDE
(Oita Univ.)
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Journal Title;Neurological Therapeutics
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Journal Code:X0110A
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ISSN:0916-8443
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VOL.23;NO.2;PAGE.107-114(2006)
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| Figure&Table&Reference;TBL.4, REF.30 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Sarcoidosis is multisystem granulomatous disease of etiology unknown, and is associated with bilateral hilar lymphadenopathy, pulmonary, skin, eyes, nervous system and muscles. Clinically recognizable nervous system and muscles involved in 5-16% and 1.4-2.3%, respectively, of patients with sarcoidosis. The incidence of subclinical neurosarcoidosis and muscular sarcoidosis, however, may be higher. Neuroradiological studies such as gallium scanning, fluorodeoxyglucose-PET scanning, MRI and CT scans are useful, and especially MRI is the most sensitive diagnostic tools for the detection and localization of neurological lesions. MRI before and after administration of gadolinium-DTPA can detect frequently subclinical or isolated sarcoidosis in the nerve system and muscles. However, MRI findings as well as serum and cerebrospinal fluid findings including angiotensin converting enzyme (ACE) level and neurophysiological findings are not specific for neurosarcoidosis and muscular sarcoidosis. Therefore, isolated sarcoidosis in the nerve sytem and muscles remain a very difficult diagnosis, particularly in the absence of systemic signs of sarcoidosis. Biopsy of nerve or muscle tissue is required to make a definite diagnosis of neurosarcoidosis or muscular sarcoidosis. Histopathological findings show characteristically reveals noncaseating granulomatous lesions, consisting of epithelioid cells, macrophages, Langhans-type giant cells, and lymphocytes, which show phenotypic cellular distribution: CD68'+' and CD4'+' cell in the center and to some extent, CD8'+' cells at the periphery. Ad hoc committee of Japanese Society of Neurology have collaborated with Japanese Sarcoidosis Society and Japanese Society of Respiratory disease to make a new diagnostic criteria of neurosarcoidosis including muscular sarcoidosis. (author abst.) |
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