Science Links Japan | A Case of Isolated CNS Sarcoidosis with Diffuse Confluent High Intensity Lesions at Bilateral Deep White Matter

A Case of Isolated CNS Sarcoidosis with Diffuse Confluent High Intensity Lesions at Bilateral Deep White Matter

Accession number;06A0610701

Title;A Case of Isolated CNS Sarcoidosis with Diffuse Confluent High Intensity Lesions at Bilateral Deep White Matter

Author; MAEDA KOJI (Hyogo Brain and Heart Center, JPN) KITA YASUSHI (Hyogo Brain and Heart Center, JPN) UEHARA SATOSHI (Hyogo Brain and Heart Center, JPN) YAMASAKI OSAMU (Hyogo Brain and Heart Center, JPN) RIKIMARU MITSUE (Hyogo Brain and Heart Center, JPN) SAJI NAOKI (Hyogo Brain and Heart Center, JPN) TABUCHI MASAYASU (Hyogo Brain and Heart Center, JPN) FURUMOTO MASARU (Hyogo Brain and Heart Center, Himeji, JPN)

Journal Title;Brain Nerve

Journal Code:Z0685A

ISSN:0006-8969

VOL.58;NO.7;PAGE.605-610(2006)

Figure&Table&Reference;FIG.2, REF.8

Pub. Country;Japan

Language;Japanese

Abstract;We reported a 60-year-old woman who suffered from isolated neurosarcoidosis. She was presenting comprehensive dysfunction and intermittent high fever. In several months she gradually developed dysorientation, amnesia, dementia. However, no focal sign such as paralysis or sensory disturbance was demonstrated. Her blood chemistry showed normal including ACE (angiotensin converting enzyme) and lysozyme. Cerebrospinal fluid revealed elevated mononuclear cells, protein, and decreased glucose level. At first we treated with antibiotics including antiviral drugs in suspect of the infectious encephalomeningitis. But no improvement was observed. The elevation of ACE in spinal fluid made us suspect of neurosarcoidosis. So intravenous predonizoron (1,000mg) was given, improving. Her high fever and mental disturbance improved. Second spinal fluid showed improvement. During the course her brain MRI revealed new bilateral diffuse confluent high intensity lesions at the deep white matters. Brain biopsy of deep matter at the right anterior lobe showed noncaseating granuloma. Since systemic work-up to detect sarcoidosis did not reveal lesions other than CNS, we considered this patient as having isolated CNS sarcoidosis. (author abst.)

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