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Sarcoidosis

Neurosarcoidosis Question

07/20/2011

Question:

My brother had sarcoidosis 25 years ago. He has had reoccurances a few times, but always in the lung. Now he basically has every symptom of neurosarcoidosis based on what I have read (excessive fatigue, tremors, hand stiffness, skin rashes, arthritis, night sweats, instability on his walking and a cough). He is one sick person. His doctors act like they never have heard of Sarcoidosis. He saw a Neurologist this week and he ordered a brain MRI with contrast, but put the diagnosis as Parkinson. My question is would the Sarcoidosis show up in a brain scan? He had a chest xray, but it showed nothing. I suggested an ACE test after reading about it on-line (which they ordered), but he takes so many meds for his diabetes and heart disease I am concerned it may not show anything. Any other suggestions.

Answer:

Dear Sir/Madam- Establishing the diagnosis of neurosarcoidosis can be very challenging. It would be unusual for the disease to become active in the brain without signs of activation in the lung, as was the case in the past. A MRI would typically show some abnormalities if his symptoms were related to neurosarcoidosis. In summary, it seems that your brother's doctors are performing the proper tests to exclude neurosarcoidosis.

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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