Elizabeth P Held1, Edward A Iglesia, Adam S Johnson, John Y Fang, Matthew H Wilson, Ty W Abel, Wendell Lake, Edward D Siew. 1. 1 Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN. 2 VA Tennessee Valley Healthcare System, Nashville, TN. 3 Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN. 4 Department of Neurology, Vanderbilt University Medical Center, Nashville, TN. 5 Division of Nephrology and Hypertension, Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, TN. 6 Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Abstract
BACKGROUND: Sarcoidosis is a presumptive autoimmune disorder characterized by the presence of noncaseating granulomas and is usually treated successfully with immunosuppression. METHODS AND RESULTS: Here, we describe the case of a 63-year-old male renal transplant recipient with a remote history of pulmonary sarcoidosis on chronic immunosuppression who developed recurrent aseptic meningitis and underwent brain biopsy revealing a diagnosis of neurosarcoidosis. CONCLUSIONS: This case highlights the possibility of recurrence of sarcoidosis in the setting of maintenance immunosuppression, the need for heightened awareness of alternative sites of recurrence of autoimmune disease, and future studies to determine the underlying mechanism of recurrence in organ transplant recipients.
BACKGROUND:Sarcoidosis is a presumptive autoimmune disorder characterized by the presence of noncaseating granulomas and is usually treated successfully with immunosuppression. METHODS AND RESULTS: Here, we describe the case of a 63-year-old male renal transplant recipient with a remote history of pulmonary sarcoidosis on chronic immunosuppression who developed recurrent aseptic meningitis and underwent brain biopsy revealing a diagnosis of neurosarcoidosis. CONCLUSIONS: This case highlights the possibility of recurrence of sarcoidosis in the setting of maintenance immunosuppression, the need for heightened awareness of alternative sites of recurrence of autoimmune disease, and future studies to determine the underlying mechanism of recurrence in organ transplant recipients.