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[Bilateral optic neuropathy revealing systemic sarcoidosis]
P Guilpain1, M A Andreu, N Cassoux
1Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France. pguilpain@wanadoo.fr
Introduction:
Although ocular involvement concerns about 25 to 60% of patients with systemic sarcoidosis, papilledema is a rare event.
Exegesis:
A 43-year-old man presented with left visual loss related to papillitis. Despite high-dose corticosteroids, visual loss became rapidly bilateral. Thoracic CT-scan showed mediastinal and parenchymal involvement. Histological study of lung, bronchial and lymphadenopathy biopsies displayed giant-cells granuloma without necrosis. Diagnosis of sarcoidosis complicated with optic neuropathy was made. Therapy combining prednisone, methotrexate and infliximab was started without significant improvement of visual acuity.
Conclusion:
This report underlines the potential severity of optic neuropathy in sarcoidosis.
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