Clinical characterization and outcomes of 85 patients with neurosarcoidosis

Abstract To analyze the frequency and clinical phenotype of neurosarcoidosis (NS) in one of the largest nationwide cohorts of patients with sarcoidosis reported from southern Europe. NS was evaluated according to the Diagnostic Criteria for Central Nervous System and Peripheral Nervous System Sarcoi...

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Autores principales: Manuel Ramos-Casals, Roberto Pérez-Alvarez, Belchin Kostov, Ricardo Gómez-de-la-Torre, Carlos Feijoo-Massó, Joel Chara-Cervantes, Blanca Pinilla, Andrés González-García, José-Salvador Garcia-Morillo, Miguel López-Dupla, Begoña De-Escalante, Javier Rascón, Patricia Perez-Guerrero, Mariona Bonet, Gracia Cruz-Caparrós, Ana Alguacil, José-Luis Callejas, Eva Calvo, Cristina Soler, Angel Robles, Borja de Miguel-Campo, Pedro Oliva-Nacarino, Jorge Estela-Herrero, Lucio Pallarés, Pilar Brito-Zerón, Yolanda Blanco, the SarcoGEAS-SEMI Registry
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Publicado: Nature Portfolio 2021
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spelling oai:doaj.org-article:1e44c96df86b41beb3c7a917cfef4cc52021-12-02T14:33:57ZClinical characterization and outcomes of 85 patients with neurosarcoidosis10.1038/s41598-021-92967-62045-2322https://doaj.org/article/1e44c96df86b41beb3c7a917cfef4cc52021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92967-6https://doaj.org/toc/2045-2322Abstract To analyze the frequency and clinical phenotype of neurosarcoidosis (NS) in one of the largest nationwide cohorts of patients with sarcoidosis reported from southern Europe. NS was evaluated according to the Diagnostic Criteria for Central Nervous System and Peripheral Nervous System Sarcoidosis recently proposed by Stern et al. Pathologic confirmation of granulomatous disease was used to subclassify NS into definite (confirmation in neurological tissue), probable (confirmation in extraneurological tissue) and possible (no histopathological confirmation of the disease). Of the 1532 patients included in the cohort, 85 (5.5%) fulfilled the Stern criteria for NS (49 women, mean age at diagnosis of NS of 47.6 years, 91% White). These patients developed 103 neurological conditions involving the brain (38%), cranial nerves (36%), the meninges (3%), the spinal cord (10%) and the peripheral nerves (14%); no patient had concomitant central and peripheral nerve involvements. In 59 (69%) patients, neurological involvement preceded or was present at the time of diagnosis of the disease. According to the classification proposed by Stern et al., 11 (13%) were classified as a definite NS, 61 (72%) as a probable NS and the remaining 13 (15%) as a possible NS. In comparison with the systemic phenotype of patients without NS, patients with CNS involvement presented a lower frequency of thoracic involvement (82% vs 93%, q = 0.018), a higher frequency of ocular (27% vs 10%, q < 0.001) and salivary gland (15% vs 4%, q = 0.002) WASOG involvements. In contrast, patients with PNS involvement showed a higher frequency of liver involvement (36% vs 12%, p = 0.02) in comparison with patients without NS. Neurosarcoidosis was identified in 5.5% of patients. CNS involvement prevails significantly over PNS involvement, and both conditions do not overlap in any patient. The systemic phenotype associated to each involvement was clearly differentiated, and can be helpful not only in the early identification of neurological involvement, but also in the systemic evaluation of patients diagnosed with neurosarcoidosis.Manuel Ramos-CasalsRoberto Pérez-AlvarezBelchin KostovRicardo Gómez-de-la-TorreCarlos Feijoo-MassóJoel Chara-CervantesBlanca PinillaAndrés González-GarcíaJosé-Salvador Garcia-MorilloMiguel López-DuplaBegoña De-EscalanteJavier RascónPatricia Perez-GuerreroMariona BonetGracia Cruz-CaparrósAna AlguacilJosé-Luis CallejasEva CalvoCristina SolerAngel RoblesBorja de Miguel-CampoPedro Oliva-NacarinoJorge Estela-HerreroLucio PallarésPilar Brito-ZerónYolanda Blancothe SarcoGEAS-SEMI RegistryNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-14 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Manuel Ramos-Casals
Roberto Pérez-Alvarez
Belchin Kostov
Ricardo Gómez-de-la-Torre
Carlos Feijoo-Massó
Joel Chara-Cervantes
Blanca Pinilla
Andrés González-García
José-Salvador Garcia-Morillo
Miguel López-Dupla
Begoña De-Escalante
Javier Rascón
Patricia Perez-Guerrero
Mariona Bonet
Gracia Cruz-Caparrós
Ana Alguacil
José-Luis Callejas
Eva Calvo
Cristina Soler
Angel Robles
Borja de Miguel-Campo
Pedro Oliva-Nacarino
Jorge Estela-Herrero
Lucio Pallarés
Pilar Brito-Zerón
Yolanda Blanco
the SarcoGEAS-SEMI Registry
Clinical characterization and outcomes of 85 patients with neurosarcoidosis
description Abstract To analyze the frequency and clinical phenotype of neurosarcoidosis (NS) in one of the largest nationwide cohorts of patients with sarcoidosis reported from southern Europe. NS was evaluated according to the Diagnostic Criteria for Central Nervous System and Peripheral Nervous System Sarcoidosis recently proposed by Stern et al. Pathologic confirmation of granulomatous disease was used to subclassify NS into definite (confirmation in neurological tissue), probable (confirmation in extraneurological tissue) and possible (no histopathological confirmation of the disease). Of the 1532 patients included in the cohort, 85 (5.5%) fulfilled the Stern criteria for NS (49 women, mean age at diagnosis of NS of 47.6 years, 91% White). These patients developed 103 neurological conditions involving the brain (38%), cranial nerves (36%), the meninges (3%), the spinal cord (10%) and the peripheral nerves (14%); no patient had concomitant central and peripheral nerve involvements. In 59 (69%) patients, neurological involvement preceded or was present at the time of diagnosis of the disease. According to the classification proposed by Stern et al., 11 (13%) were classified as a definite NS, 61 (72%) as a probable NS and the remaining 13 (15%) as a possible NS. In comparison with the systemic phenotype of patients without NS, patients with CNS involvement presented a lower frequency of thoracic involvement (82% vs 93%, q = 0.018), a higher frequency of ocular (27% vs 10%, q < 0.001) and salivary gland (15% vs 4%, q = 0.002) WASOG involvements. In contrast, patients with PNS involvement showed a higher frequency of liver involvement (36% vs 12%, p = 0.02) in comparison with patients without NS. Neurosarcoidosis was identified in 5.5% of patients. CNS involvement prevails significantly over PNS involvement, and both conditions do not overlap in any patient. The systemic phenotype associated to each involvement was clearly differentiated, and can be helpful not only in the early identification of neurological involvement, but also in the systemic evaluation of patients diagnosed with neurosarcoidosis.
format article
author Manuel Ramos-Casals
Roberto Pérez-Alvarez
Belchin Kostov
Ricardo Gómez-de-la-Torre
Carlos Feijoo-Massó
Joel Chara-Cervantes
Blanca Pinilla
Andrés González-García
José-Salvador Garcia-Morillo
Miguel López-Dupla
Begoña De-Escalante
Javier Rascón
Patricia Perez-Guerrero
Mariona Bonet
Gracia Cruz-Caparrós
Ana Alguacil
José-Luis Callejas
Eva Calvo
Cristina Soler
Angel Robles
Borja de Miguel-Campo
Pedro Oliva-Nacarino
Jorge Estela-Herrero
Lucio Pallarés
Pilar Brito-Zerón
Yolanda Blanco
the SarcoGEAS-SEMI Registry
author_facet Manuel Ramos-Casals
Roberto Pérez-Alvarez
Belchin Kostov
Ricardo Gómez-de-la-Torre
Carlos Feijoo-Massó
Joel Chara-Cervantes
Blanca Pinilla
Andrés González-García
José-Salvador Garcia-Morillo
Miguel López-Dupla
Begoña De-Escalante
Javier Rascón
Patricia Perez-Guerrero
Mariona Bonet
Gracia Cruz-Caparrós
Ana Alguacil
José-Luis Callejas
Eva Calvo
Cristina Soler
Angel Robles
Borja de Miguel-Campo
Pedro Oliva-Nacarino
Jorge Estela-Herrero
Lucio Pallarés
Pilar Brito-Zerón
Yolanda Blanco
the SarcoGEAS-SEMI Registry
author_sort Manuel Ramos-Casals
title Clinical characterization and outcomes of 85 patients with neurosarcoidosis
title_short Clinical characterization and outcomes of 85 patients with neurosarcoidosis
title_full Clinical characterization and outcomes of 85 patients with neurosarcoidosis
title_fullStr Clinical characterization and outcomes of 85 patients with neurosarcoidosis
title_full_unstemmed Clinical characterization and outcomes of 85 patients with neurosarcoidosis
title_sort clinical characterization and outcomes of 85 patients with neurosarcoidosis
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/1e44c96df86b41beb3c7a917cfef4cc5
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