中枢神経病変により多彩な症状をきたしたサルコイドーシスの一例

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  • チュウスウ シンケイ ビョウヘン ニ ヨリ タサイ ナ ショウジョウ オ キタシタ サルコイドーシス ノ イチレイ
  • A Case of Sarcoidosis with Various Symptom due to Central Nervous System Involvement

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A 30-year-old man was admitted because of thirst, polyuria, nausea, vomiting and fever.　The electrocardiogram showed QT prolongation, and his chest CT revealed an abnormal lung shadow and systemic multiple lymph node enlargement.　The histopathology finding of lymph node biopsy demonstrated a caseating epithelioid granuloma without evidence of tuberculosis.　He was diagnosed with sarcoidosis based on diagnostic criteria of sarcoidosis.　His brain MRI revealed an intrasellar tumor compressing the pituitary gland, which causes a central nervous system （CNS）involvement of sarcoidosis.　The blood examination showed the decreased level of pituitary hormone including of ACTH, TSH, LH, FSH, and ADH.　His clinical manifestations and intrasellar lesion was improved with administration of oral steroid, but his hypopituitarism still needed hormone replacement therapy.　CNS involvement of sarcoidosis is easy to induce irreversible changes in short term.　Our present case indicates the significance of early treatment for sarcoidosis with CNS involvement.

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  • 秋田医学

    秋田医学 44 (3/4), 155-161, 2018-03

    秋田医学会

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