Neurosarcoidosis Masquerading as Giant Cell Arteritis With Incidental Meningioma

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Title Neurosarcoidosis Masquerading as Giant Cell Arteritis With Incidental Meningioma
Creator Omar M. Solyman; Maria Adelita Vizcaino; Roxana Fu; Amanda D. Henderson
Affiliation Wilmer Eye Institute (OMS, RF, ADH), Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pathology (MAV), Division of Neuro-Ophthalmology (ADH, OMS); Division of Oculoplastics (RF), Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Pathology, Mayo Clinic, Rochester, Minnesota
Abstract We present a case of vision loss secondary to neurosarcoidosis, which initially presented with severe bilateral vision loss, temporal headaches, and elevated erythrocyte sedimentation rate, concerning for giant cell arteritis. However, temporal artery biopsy was negative. Initial neuroimaging features were misinterpreted to represent a meningioma that did not account for his clinical presentation. Clinical course, including atypically rapid enlargement of presumed meningioma, development of skin lesions, appearance of optic nerve enhancement on MRI, and steroid response, strongly increased suspicion for sarcoidosis. Biopsy of a skin lesion demonstrated noncaseating granulomatous inflammation, consistent with sarcoidosis.
Subject Aged; Biopsy; Blindness / diagnosis; Blood Sedimentation; Diagnosis, Differential; Giant Cell Arteritis / diagnosis; Giant Cell Arteritis / drug therapy; Glucocorticoids / therapeutic use; Headache / diagnosis; Humans; Infusions, Intravenous; Magnetic Resonance Imaging; Male; Methylprednisolone / therapeutic use; Optic Nerve Diseases / diagnostic imaging; Sarcoidosis / diagnosis; Sarcoidosis / drug therapy
OCR Text Show
Date 2021-03
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, March 2021, Volume 41, Issue 1
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s66ynk7b
Setname ehsl_novel_jno
ID 1765143
Reference URL https://collections.lib.utah.edu/ark:/87278/s66ynk7b
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