Neurosarcoidosis: guidance for the general neurologist

Arquivos de Neuro-Psiquiatria

Lívia Almeida Dutra¹  Pedro Braga-neto¹  Ricardo Araújo Oliveira¹  José Luiz Pedroso¹  Agessandro Abrahão¹  Orlando Graziani Povoas Barsottini¹ 

[1] ,Universidade Federal de São Paulo Department of Neurology and Neurosurgery Division of General NeurologySão Paulo SP ,Brazil

关键词: sarcoidosis;    neurosarcoidosis;    methotrexate;    azathioprine;    cyclophosphamide;    infliximab;    sarcoidose;    neurosarcoidose;    metotrexato;    azatioprina;    ciclofosfamida;    infliximabe;   

DOI  :  10.1590/S0004-282X2012000400014

来源: SciELO

【 摘 要 】

Neurosarcoidosis (NS) more commonly occurs in the setting of systemic disease. The diagnosis is based on a clinical history suggestive of NS, presence of noncaseating granulomas, and supportive evidence of sarcoid pathology, laboratory, and imaging studies. NS could involve any part of the nervous system and often demands high doses of steroids for symptom control. It presents low response to isolated steroids administration and frequently requires immunosuppressive agents. In NS, lymphocytes are polarized toward an excessive Th1 response, leading to overproduction of TNF-alpha and INF-gama, as well as lL-2 and IL-15. Infliximab, a chimeric monoclonal antibody that neutralizes the biological activity of TNF-alpha, is a new option in the NS treatment. We revised pathophysiology, clinical manifestations, diagnostic work up, and treatment of NS as guidance for the general neurologist.

【 授权许可】

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