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Sarcoidosis

Treatment in Neurosarcoidosis

01/04/2011

Question:

I`m a pediatrician and my friend was diagnosed sarcoidosis in August. He had problems in his limphatic system,liver, lungs and spleen. Prednisone made to be better his affected organs but he started neurological symptoms ( language and visual problems)a month later. Resonance make the diagnosis (he has affected the left brain (white matter). His treatment is prednisone and ciclophosphamide.Is there some specific hospital or doctor with experience that you Know?

Answer:

Dear Doctor- Neurosarcoidosis can be challenging to diagnose and treat. Corticosteroids and cyclophosphamide can be an effective regimen; however, the risk of bladder cancer is very high in patients treated with cyclophosphamide for long periods of time, which is likely to be the case for neurosarcoidosis. Reasonable alternatives to cyclophosphamide exist (e.g., methotrexate, anti-TNF drugs, azathioprine), and it is best that these drugs are managed by experienced experts. 

Regional experts in the management of sarcoidosis can be found by searching the Foundation for Sarcoidosis Research website (http://www.stopsarcoidosis.org/) under the "Patient Info" drop-down menu. Sincerely, Elliott Crouser.

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Response by:

Elliott D Crouser, MD Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University