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Chronic meningitis as the first presentation of sarcoidosis: an uncommon finding
Zahra Vahabi1, Hajir Sikaroodi, Siamak Abdi
1Neurology Department, Shariati Hospital, Tehran University of Medical Sceinces, Tehran, Iran.
Iranian Journal of Neurology
|November 20, 2013
Abstract:
We describe a 40-year-old woman presenting with headache, nausea, episodic amnesia and blurred optic disc. Brain MRI disclosed diffuse leptomeningeal enhancement. CSF analysis showed aseptic meningitis with elevated ACE level. Neurosarcoidosis was diagnosed based on granulomatosis changes on tissue biopsy.
Insights
A case study details a woman with neurological symptoms like headache and amnesia. Diagnosis revealed neurosarcoidosis, a rare inflammatory condition affecting the brain and meninges.
Area of Science:
- Neurology
- Immunology
- Pathology
Background:
- Neurosarcoidosis is a rare multisystem inflammatory disease.
- It can present with diverse neurological manifestations.
- Early diagnosis is crucial for effective management.
Observation:
- A 40-year-old woman presented with headache, nausea, episodic amnesia, and blurred optic disc.
- Brain MRI revealed diffuse leptomeningeal enhancement.
- Cerebrospinal fluid (CSF) analysis indicated aseptic meningitis with an elevated angiotensin-converting enzyme (ACE) level.
Findings:
- Tissue biopsy confirmed granulomatous changes, leading to a diagnosis of neurosarcoidosis.
- The combination of clinical presentation, imaging, and CSF findings supported the diagnosis.
- Elevated ACE levels are a key biomarker in suspected sarcoidosis.
Implications:
- This case highlights the importance of considering neurosarcoidosis in patients with unexplained neurological and meningeal signs.
- Diagnostic challenges in neurosarcoidosis underscore the need for integrated clinical and pathological evaluation.
- Timely diagnosis and treatment can prevent irreversible neurological damage and improve patient outcomes.
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