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[Peripheral neuropathies disclosing sarcoidosis].

B Brochet1, P Louiset, A Lagueny

  • 1Clinique Neurologique, Hôpital Pellegrin, Bordeaux.

Revue Neurologique
|January 1, 1988
PubMed
Summary

Sarcoidosis can cause asymmetrical polyneuropathy, affecting nerves and leading to Wallerian degeneration. This case highlights sarcoidosis involvement in hepatic and neuromuscular tissues.

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Area of Science:

  • Neurology
  • Immunology
  • Pathology

Background:

  • Sarcoidosis is a multisystem inflammatory disease characterized by non-caseating granulomas.
  • Neurological involvement in sarcoidosis (neurosarcoidosis) can manifest in various ways, including peripheral neuropathy.

Observation:

  • A 54-year-old woman presented with asymmetrical polyneuropathy, hepatitis, and hypercalcemia.
  • Hepatic and neuromuscular biopsies confirmed sarcoidosis.
  • Electrophysiological studies revealed a clear neurogenic, axonal polyneuropathy.

Findings:

  • Ultrastructural nerve examination identified sarcoid granulomas within epineurium, perineurium, and endoneurium.
  • Evidence of Wallerian degeneration was observed in the nerve tissue.
  • No primary demyelinating features were detected, indicating an axonal process.

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Implications:

  • This case underscores the diverse presentations of sarcoidosis, emphasizing its potential to cause axonal polyneuropathy.
  • The findings suggest that nerve compression or immune-mediated angiitis could be etiological mechanisms in neurosarcoidosis.
  • Understanding these mechanisms is crucial for diagnosing and managing neurosarcoidosis effectively.