Neurosarcoidosis: Diagnostic Challenges and Mimics A Review.

IF 5.4 2区医学 Q1 ALLERGY

Current Allergy and Asthma Reports Pub Date : 2023-07-01 DOI:10.1007/s11882-023-01092-z

Jeffrey Shen, Elijah Lackey, Suma Shah

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引用次数: 1

Abstract

Purpose of review: Neurosarcoidosis is a rare manifestation of sarcoidosis that is challenging to diagnose. Biopsy confirmation of granulomas is not sufficient, as other granulomatous diseases can present similarly. This review is intended to guide the clinician in identifying key conditions to exclude prior to concluding a diagnosis of neurosarcoidosis.

Recent findings: Although new biomarkers are being studied, there are no reliable tests for neurosarcoidosis. Advances in serum testing and imaging have improved the diagnosis for key mimics of neurosarcoidosis in certain clinical scenarios, but biopsy remains an important method of differentiation. Key mimics of neurosarcoidosis in all cases include infections (tuberculosis, fungal), autoimmune disease (vasculitis, IgG4-related disease), and lymphoma. As neurosarcoidosis can affect any part of the nervous system, patients should have a unique differential diagnosis tailored to their clinical presentation. Although biopsy can assist with excluding mimics, diagnosis is ultimately clinical.

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神经结节病:诊断挑战和模拟综述。

综述目的:神经结节病是一种罕见的结节病，诊断困难。活检证实肉芽肿是不够的，因为其他肉芽肿性疾病也可能出现类似的症状。本综述旨在指导临床医生在确定神经结节病诊断之前确定排除的关键条件。最新发现:虽然新的生物标志物正在研究中，但尚无可靠的神经结节病检测方法。血清检测和影像学的进步改善了某些临床情况下神经结节病关键模拟物的诊断，但活检仍然是一种重要的鉴别方法。所有病例中神经结节病的主要模拟症状包括感染(结核、真菌)、自身免疫性疾病(血管炎、igg4相关疾病)和淋巴瘤。由于神经结节病可以影响神经系统的任何部分，患者应该有一个独特的鉴别诊断量身定制的临床表现。虽然活检可以帮助排除模拟，诊断最终是临床。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Allergy and Asthma Reports 医学-过敏

CiteScore

11.20

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of Current Allergy and Asthma Reports is to systematically provide the views of highly selected experts on current advances in the fields of allergy and asthma and highlight the most important papers recently published. All reviews are intended to facilitate the understanding of new advances in science for better diagnosis, treatment, and prevention of allergy and asthma. We accomplish this aim by appointing international experts in major subject areas across the discipline to review select topics emphasizing recent developments and highlighting important new papers and emerging concepts. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. Over a one- to two-year period, readers are updated on all the major advances in allergy and asthma.