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[Chronic meningitis associated with lymph node sarcoidosis].

P Thielemans, E Jann

    Acta Clinica Belgica
    |January 1, 1989
    PubMed
    Summary

    This case study highlights a rare instance of sarcoidosis presenting with Löfgren's syndrome and meningitis in a diabetic patient. Corticosteroid treatment effectively managed symptoms and inflammatory markers.

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    Area of Science:

    • Internal Medicine
    • Neurology
    • Rheumatology

    Background:

    • Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
    • Löfgren's syndrome is a clinical presentation of sarcoidosis characterized by bilateral hilar adenopathy, erythema nodosum, and acute polyarthritis.
    • Neurological involvement in sarcoidosis, or neurosarcoidosis, can manifest in various ways, including meningitis.

    Observation:

    • A 59-year-old woman with diabetes mellitus presented with symmetrical polyarthralgia and ketoacidosis.
    • Clinical examination revealed bilateral hilar adenopathy and an erythematous rash on the lower limbs.
    • The patient subsequently developed symptoms of chronic meningeal irritation.

    Findings:

    • Lymph node biopsy confirmed the diagnosis of sarcoidosis.
    • Cerebrospinal fluid analysis showed elevated albumin content and lymphocytosis.
    • Bronchoalveolar lavage also indicated lymphocytosis.

    Implications:

    • This case demonstrates a rare association of sarcoidosis, Löfgren's syndrome, and meningitis in a patient with diabetes.
    • The findings underscore the importance of considering sarcoidosis in the differential diagnosis of patients presenting with polyarthralgia, hilar adenopathy, and neurological symptoms.
    • Successful management with corticosteroids suggests their efficacy in controlling inflammation in this complex presentation.

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