1.Concurrent intermediate uveitis and an enhancing intracranial lesion as the initial manifestation of sarcoidosis.
Elaine H Z HUANG ; Kim-Teck YEO ; Wee-Kiak LIM ; Cora Y P CHAU ; William Y K HWANG
Annals of the Academy of Medicine, Singapore 2006;35(4):266-269
<p>INTRODUCTIONPosterior segment involvement has been described to be associated with central nervous system involvement in sarcoidosis as a result of direct sarcoid tissue infiltration or mass effect of a cerebral lesion. However, isolated intermediate uveitis occurring concurrently with central nervous system involvement prior to extensive systemic disease is rare.p><p>CLINICAL PICTUREWe describe a patient with neuro-ophthalmic manifestations of intermediate uveitis and an enhancing basal ganglia lesion at initial presentation, in the absence of extensive systemic disease.p><p>TREATMENTHe was treated with high-dose systemic steroids which was progressively tailed down over 6 months.p><p>OUTCOMEThere was prompt resolution of vitritis with good preservation of visual acuity.p><p>CONCLUSIONThe difficulties of the initial diagnosis of sarcoidosis and the indications for initiation of steroid therapy are illustrated. We use this case to emphasise the need for a high clinical suspicion of sarcoidosis in the presence of similar unusual and seemingly unrelated combinations of neurological manifestations so as to facilitate the prompt institution of appropriate treatment when indicated.p>
Adult
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Angiography
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Basal Ganglia
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diagnostic imaging
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physiopathology
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Brain Ischemia
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complications
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diagnosis
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Comorbidity
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Diagnosis, Differential
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Humans
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Magnetic Resonance Imaging
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Male
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Sarcoidosis
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complications
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diagnosis
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Time Factors
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Tomography, X-Ray Computed
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Uveitis
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complications
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diagnosis