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• W4387253222 abstract "SESSION TITLE: Lung Pathology Case Report Posters 7 SESSION TYPE: Case Report Posters PRESENTED ON: 10/09/2023 12:00 pm - 12:45 pm INTRODUCTION: Intrathoracic involvement is the hallmark of sarcoidosis. However, pulmonary symptoms can be absent in the presence of other organs specific symptoms. Here we present a case with extensive neurological involvement in a patient without any pulmonary symptoms. CASE PRESENTATION: A 37-year-old African American woman with no past medical history presented with three weeks of bilateral lower extremity weakness, saddle anesthesia, urinary incontinence, and paraplegia. MRI of the spine revealed an abnormal increase in T2 signaling involving the entire spinal cord, consistent with LETM. Chest imaging revealed bilateral infiltrates as well as hilar and mediastinal lymphadenopathy. Transbronchial lung biopsy and fine needle aspiration of the lymph nodes were positive for noncaseating granuloma consistent with sarcoidosis. A diagnosis of neurosarcoidosis was made. She failed steroid therapy but responded to infliximab with improved symptoms and functional capacity. Repeat MRI re-imaging in 3 months had drastic improvements. DISCUSSION: Sarcoidosis can affect the spinal cord via direct infiltration of the spinal cord parenchyma, extradural space, and leptomeninges and through the activation and release of inflammatory markers leading to spinal cord inflammation. Longitudinally Extensive Transverse Myelitis (LETM) as a solo presentation of sarcoidosis is extremely rare, occurring in less than 1% of the population. CONCLUSIONS: LETM should always be considered a differential in patients with sarcoidosis who develop acute paralysis, and not all sarcoidosis presents with pulmonary symptoms. REFERENCE #1: Mañá, J., Rubio-Rivas, M., Villalba, N. M. M., Marcoval, J., Iriarte, A., Molina-Molina, M., Llatjós, R., García, O., Martínez-Yélamos, S., Vicens-Zygmunt, V., Gámez, C., Pujol, R. M., & Corbella, X. (2017). Multidisciplinary approach and long-term follow-up in a series of 640 consecutive patients with sarcoidosis. Medicine, 96(29), e7595. https://doi.org/10.1097/md.0000000000007595 REFERENCE #2: Bradshaw, M. J., Pawate, S., Koth, L. L., Cho, T. A., & Gelfand, J. M. (2021). Neurosarcoidosis. Neuroimmunology and Neuroinflammation, 8(6), e1084. https://doi.org/10.1212/nxi.0000000000001084 REFERENCE #3: Scott, T. W., Yandora, K., Valeri, A., Chieffe, C., & Schramke, C. J. (2007). Aggressive Therapy for Neurosarcoidosis. Archives of Neurology, 64(5), 691. https://doi.org/10.1001/archneur.64.5.691 DISCLOSURES: No relevant relationships by Ezekiel Akpan No relevant relationships by Chisom Asuzu No relevant relationships by Moses Bachan No relevant relationships by Sindhuja Dogga No relevant relationships by ADEJOKE JOHNSON No relevant relationships by Zinobia Khan" @default.
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• W4387253222 date "2023-10-01" @default.
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• W4387253222 title "A RARE NEUROLOGICAL MANIFESTATION OF SARCOIDOSIS WITHOUT PULMONARY SYMPTOMS: ACUTE LONGITUDINALLY EXTENSIVE TRANSVERSE MYELITIS (LETM)" @default.
• W4387253222 doi "https://doi.org/10.1016/j.chest.2023.07.3040" @default.
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