Longitudinally extensive transverse myelitis as an initial manifestation of sarcoidosis: A rare case and its management.

Autor: Kumar A; Shaheed Mohtarma Benazir Bhutto Medical University Larkana Pakistan., Bai R; Shaheed Mohtarma Benazir Bhutto Medical University Larkana Pakistan., Sanjna F; Shaheed Mohtarma Benazir Bhutto Medical College Layari Pakistan., Sonam F; Chandka Medical College Larkana Pakistan., Karishma F; Ghulam Muhammad Mahar Medical College Sukkur Pakistan., Girish F; Ghulam Muhammad Mahar Medical College Sukkur Pakistan., Ali MZ; Mayo Hospital Lahore Pakistan., Singh B; Nobel Medical College Kanchanbari Pokhara 56700 Nepal., Ahmed Z; Mayo Hospital Lahore Pakistan., Mandal A; Chitwan Medical College Bharatpur Nepal.
Jazyk: angličtina
Zdroj: Clinical case reports [Clin Case Rep] 2024 Jul 07; Vol. 12 (7), pp. e9135. Date of Electronic Publication: 2024 Jul 07 (Print Publication: 2024).
DOI: 10.1002/ccr3.9135
Abstrakt: Key Clinical Message: Sarcoidosis-induced LETM represents a rare but life-threatening neurological manifestation of sarcoidosis, characterized by spinal cord inflammation, and associated neurological deficits. Sarcoidosis should be included in the differential diagnosis of LETM, particularly in patients with no lung involvement. Prompt recognition and management are obligatory to optimize outcomes and prevent long-term disability.
Abstract: Sarcoidosis is a multisystem inflammatory granulomatous disorder characterized by the formation of noncaseating granulomas. Although sarcoidosis commonly affects the skin, lymph nodes, and lungs, neurological involvement of sarcoidosis has also been reported. Longitudinally extensive transverse myelitis (LETM) is a rare but well-documented serious manifestation of neuroscoidosis. We report a case of LETM caused by sarcoidosis in a 53-year-old male who presented with progressive bilateral lower extremity weakness, urinary retention, and paresthesia. Laboratory evaluations revealed elevated inflammatory markers. Magnetic resonance imaging of the spine showed hyperintense signals consistent with transverse myelitis. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis and elevated protein levels. Chest computed tomography showed hilar lymphadenopathy. A biopsy of the intrathoracic lymph node showed noncaseating granulomas consistent with sarcoidosis. A diagnosis of sarcoidosis-induced LETM was made after ruling out all other possible etiologies. His condition improved gradually after starting high-dose prednisone, mycophenolate, and rehabilitation strategies. Our case underscores the importance of prompt diagnosis and management of sarcoidosis-induced LETM and highlights that sarcoidosis must be included among differential diagnoses of LETM, especially in cases with no lung involvement.
Competing Interests: The authors declare no conflict of interest.
(© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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