Abstract Details

Title Identifying Multiple Sclerosis in Patients with Systemic Sarcoidosis

Topic Neurotoxicology

Presentation(s) P06 - (-)

Poster/Presentation
Number 214

Objective

Background BACKGROUND: For sarcoidosis patients who develop neurologic symptoms, accurate diagnosis may be confounded and biased toward neurosarcoidosis. While NS is a reasonable element of differential diagnosis in these cases, other concurrent neurologic conditions such as multiple sclerosis may occur independently.

Design/Methods DESIGN/METHODS: We retrospectively examined records of 302 patients referred to the Neurosarcoidosis and MS clinics at Johns Hopkins Hospital between 2000 and 2011. These patients were referred for neurologic complaints suspected to be related to sarcoidosis. We categorized the patients based on the presence or absence of systemic sarcoidosis, central and peripheral neurologic symptoms, and final diagnosis.

Results RESULTS: Of the 302 patients referred, 132 were ultimately diagnosed with NS (with degrees of confidence: possible, probable, or definite). However, 26 patients with prior sarcoidosis were found to have concurrent CNS disease that was not neurosarcoidosis. Among these 26 patients, six had MS as determined by clinical and MRI features. These six MS cases represented 4.8% of the patients with neurologic complaints following previously diagnosed systemic sarcoidosis. Of the remaining patients with systemic sarcoidosis, 22 had peripheral neuropathy and 77 did not have neurologic dysfunction. Forty-five patients had evidence of CNS inflammation without systemic symptoms or other confirmed diagnoses.

Conclusions CONCLUSIONS: A previous diagnosis of systemic sarcoidosis does not necessarily imply that subsequent CNS disease is neurosarcoidosis. Multiple sclerosis and other neurologic conditions can occasionally occur after or simultaneously with systemic sarcoidosis. Accurate diagnosis is essential as treatment and management options differ for these conditions.

Authors/Disclosures
Dorlan J. Kimbrough, MD (Duke University) PRESENTER	Dr. Kimbrough has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for CVS.
Maria I. Reyes-Mantilla, MD (Johns Hopkins University, Neurology)	Dr. Reyes-Mantilla has nothing to disclose.
Jorge A. Jimenez Arango, MD	No disclosure on file
	No disclosure on file
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology)	The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .

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