Sarcoidosis presenting as senile dementia

Area of Science:

• Neurology
• Immunology
• Pathology

Background:

• Neurosarcoidosis is a rare condition affecting the central nervous system.
• Dementia is a common presentation, but typically seen in younger individuals.

Observation:

• A 68-year-old woman presented with progressive dementia, initially manifesting as memory loss and mild anomia.
• The case exhibited limited pre-mortem signs of systemic sarcoidosis and a significantly elevated cerebrospinal fluid protein level (2028 mg/dL).

Findings:

• Autopsy confirmed cerebral sarcoidosis in the index case.
• This case challenges the typical demographic and clinical presentation of neurosarcoidosis-associated dementia, with only one prior case reported in individuals over 65 and few presenting as degenerative dementia.

Implications:

• Cerebral sarcoidosis should be considered in the differential diagnosis of dementia, even in older patients.
• The high cerebrospinal fluid protein concentration, while unusual, was a key finding.
• Prompt diagnosis and treatment of neurosarcoidosis can potentially reverse or halt cognitive decline.