Jeanne Gosselin1, Chantal Roy-Hewitson2, Sean S M Bullis3, John C DeWitt4, Bruno P Soares5, Sidarth Dasari6, Alana Nevares7. 1. Division of Rheumatology and Clinical Immunology, Robert Larner, MD College of Medicine at the University of Vermont and University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT, 05401, USA. Jeanne.Gosselin2@uvmhealth.org. 2. Department of Neurosciences, Division of Neuroimmunology, Robert Larner, MD College of Medicine at the University of Vermont and University of Vermont Medical Center, Burlington, VT, USA. 3. Division of Infectious Disease, Robert Larner, MD College of Medicine at the University of Vermont and University of Vermont Medical Center, Burlington, VT, USA. 4. Department of Pathology and Laboratory Medicine, Robert Larner, MD College of Medicine at the University of Vermont and University of Vermont Medical Center, Burlington, VT, USA. 5. Division of Neuroradiology, Department of Radiology, Robert Larner, MD College of Medicine at the University of Vermont and University of Vermont Medical Center, Burlington, VT, USA. 6. Department of Neurosciences, Division of Neuroimmunology, University of Vermont Medical Center, Burlington, VT, USA. 7. Division of Rheumatology and Clinical Immunology, Robert Larner, MD College of Medicine at the University of Vermont and University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT, 05401, USA.
Abstract
PURPOSE OF REVIEW: The aim of this review is to provide an update of clinical presentation, diagnosis, differential diagnoses, and treatment according to recent evidence. RECENT FINDINGS: Neurosarcoidosis remains a diagnosis of exclusion, with infectious and malignant etiologies recognized as important mimickers. Corticosteroids remain as first-line therapy. In recent years, however, studies have demonstrated the effectiveness of anti-tumor necrosis factor (anti-TNF) therapy in the treatment of neurosarcoidosis, leading to improved outcomes. Neurosarcoidosis is a granulomatous disease with protean manifestations that may affect any part of the central and peripheral nervous system. It has many mimickers, and potentially devastating complications necessitating long-term follow-up. Early initiation of treatment, particularly with anti-TNF therapy, may lead to better outcomes and fewer relapses. There is an unmet need for randomized controlled trials that provide robust data to guide therapy and the long-term management of neurosarcoidosis patients.
PURPOSE OF REVIEW: The aim of this review is to provide an update of clinical presentation, diagnosis, differential diagnoses, and treatment according to recent evidence. RECENT FINDINGS: Neurosarcoidosis remains a diagnosis of exclusion, with infectious and malignant etiologies recognized as important mimickers. Corticosteroids remain as first-line therapy. In recent years, however, studies have demonstrated the effectiveness of anti-tumor necrosis factor (anti-TNF) therapy in the treatment of neurosarcoidosis, leading to improved outcomes. Neurosarcoidosis is a granulomatous disease with protean manifestations that may affect any part of the central and peripheral nervous system. It has many mimickers, and potentially devastating complications necessitating long-term follow-up. Early initiation of treatment, particularly with anti-TNF therapy, may lead to better outcomes and fewer relapses. There is an unmet need for randomized controlled trials that provide robust data to guide therapy and the long-term management of neurosarcoidosis patients.
Authors: R P Baughman; A S Teirstein; M A Judson; M D Rossman; H Yeager; E A Bresnitz; L DePalo; G Hunninghake; M C Iannuzzi; C J Johns; G McLennan; D R Moller; L S Newman; D L Rabin; C Rose; B Rybicki; S E Weinberger; M L Terrin; G L Knatterud; R Cherniak Journal: Am J Respir Crit Care Med Date: 2001-11-15 Impact factor: 21.405
Authors: Robert P Baughman; Shelli Field; Ulrich Costabel; Ronald G Crystal; Daniel A Culver; Marjolein Drent; Marc A Judson; Gerhard Wolff Journal: Ann Am Thorac Soc Date: 2016-08