Sarcoidosis neurologic

In case series, CP has been useful in the treatment of scleroderma-associated pulmonary fibrosis (183-186). This benefit was confirmed in two large randomized, placebo-controlled trials of either oral (187) or intermittent, IV CP (147). CP has also been used in IPF (4,188), nonspecific interstitial lung disease (189,190), and to treat refractory sarcoidosis (usually neurologic disease) (191-193). 

Lower EE, Broderick JP, Brott TG, et al. Diagnosis and management of neurologic sarcoidosis. Arch Intern Med 1997 157 1864—1868. 

Sharma OP. Effectiveness of chloroquine and hydroxychloroquine in treating selected patients with sarcoidosis with neurologic involvement. Arch Neurol 1998 ... 

Clinically apparent involvement of the nervous system occurs in 5% to 15% of sarcoidosis patients (143,144). However as with other forms of sarcoidosis, asymptomatic neurologic disease is much more frequent (145,146). Approximately 15% of sarcoidosis deaths in the United States are attributable to neurosarcoidosis (147). In ACCESS, sarcoidosis was more common in women than men [28/468 (6.0%) versus 6/268 (2.2%), chi-square 7.28, p < 0.01) (2). There was no predilection on the basis of age or race. 

Neurosarcoidosis most frequently involves the cranial nerves (143,146). A peripheral seventh nerve palsy (Bell s Palsy) is the most common neurologic manifestation of sarcoidosis (29,146). It may be unilateral, bilateral, and frequently predates the diagnosis of sarcoidosis (146). Any other cranial nerve may be affected, and in many series the nerves supplying the extraocular muscles or optic nerves are not rarely involved (148-150). 

Stem BJ, Kritnholz A, Johns C, et al. Sarcoidosis and its neurologic manifestations. Arch Neurol 1985 42 909-917. 

Powers WJ, MiUer EM. Sarcoidosis mimicking gUoma case report and review of intercranial sarcoidosis like mass lesions. Neurology 1981 31 907-910. 

Delaney P. Neurologic manifestations in sarcoidosis review of the literature, with a report of 23 cases. Ann Intern Med 1977 87 336-345. 

Kidd D, Benyon HLC. The neurological compheations of systemic sarcoidosis. Sarcoidosis Vase Diffuse Lung Dis 2003 20 85-94. 

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