Abstract
A case with sarcoidosis involving the central nervous system (CNS) is presented. A 63 year-old male, who had been troubled with cerebellar ataxia, dysmetria and asynergia, was diagnosed as having sarcoidosis by open lung biopsy.
Chest X-ray film showed unilateral hilar lymphadenopathy, and accumulation of 67Ga citrates in the bilateral hilar lymph nodes were observed. A tuberculine test was negative. Although CT scans showed no intracranial mass lesions, cerebrospinal fluid (CSF) examination disclosed lymphocyte pleocytosis and elevated protein, which was compatible with the findings of CNS sarcoidosis.
Treatment by 60mg/day prednisolone resulted in improvement of symptoms. Even though cerebellar biopsy was not performed, the clinical data and course strongly suggested sarcoidosis involving the CNS.
The incidence of involvement of the CNS in sarcoidosis is about 5% in the literature, and many of these cases were very resistant to treatment. Fortunately, 60mg/day prednisolone (p. o.) in this patient markedly improved symptoms and clinical data.
