Work

Neurosarcoidosis With Panhypopituitarism: Two Cases and Literature Review

Year: 2024

Type: article

Abstract: Neurosarcoidosis (NS) with hypothalamic-pituitary (HP) involvement (HP-NS) is a rare clinical condition, conferring variable hormonal deficits that are typically irreversible. Here, we present 2 cases of NS with panhypopituitarism. The first patient presented with cauda equina syndrome and arginine vasopressin deficiency, while the second developed recurrent optic neuritis and vision loss in the setting of a sellar mass. In the first case, neurological symptoms resolved after therapy with high-dose glucocorticoids, infliximab, and methotrexate; while in the second, visual restoration followed resection of the granulomatous tissue and immunosuppressive therapy. In both cases, pituitary dysfunction persisted despite neurological improvement. We contextualized the presentations and outcomes through a literature review of HP-NS case reports and case series. This revealed high rates of extraneurologic sarcoidosis in HP-NS patients with panhypopituitarism, while underscoring the need for hormonal replacement-as endocrinopathies rarely respond to sarcoidosis-directed immunosuppression.

Source: JCEM Case Reports

DOI: 10.1210/jcemcr/luae141

Authors: Ewelina Niedzialkowska, Tatjana Blazin, Daniel Shelden, Eric D Buras

Institutions: Beaumont Health, Corewell Health William Beaumont University Hospital, Corewell Health Trenton Hospital, University of Michigan, Michigan Medicine

Language: English

Topic: Sarcoidosis and Beryllium Toxicity Research

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,300