Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 34-year-old patient was treated four weeks before his death for a recurrent binocular iritis. He died with clinical symptoms of a cerebral respiratory paresis. The diagnosis of epithilial cells sarcoidosis was made only after histological post mortem examination. It was a cerebral form of chronic disseminated encephalomeningitis with a vascular component. Typical granulomes were found in several organs and also in conjunctiva, ciliary body, choroid and optic nerve.
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PMID:[Generalized sarcoidosis with brain and eye participation]. 115 64

We report a case of pulmonary sarcoidosis, which initially presented as a left apical infiltrate. The later course mimicked a pulmonary neoplasm, with left upper lobe atelectasis secondary to bronchial stenosis, resulting from both endobronchial sarcoidosis and extrinsic compression by enlarged lymph nodes. Extrinsic pressure from sarcoid nodes on the left main pulmonary artery and recurrent laryngeal nerve, also caused a reduction in pulmonary parenchymal perfusion and left vocal cord paresis.
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PMID:Tumour-like presentation of pulmonary sarcoidosis. 148 78

Twelve years following the diagnosis of a histologically proved Sarcoidosis, a patient developed a central paresis of one lower limb. Two years later, tetraparesis, bladder dysfunction, ataxia and an internuclear bilateral ophthalmoplegia occurred. In CSF oligoclonal IgG without dysfunction of the blood brain barrier was found. On the basis of these data multiple sclerosis was diagnosed.
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PMID:[Simultaneous occurrence of sarcoidosis and MS or sarcoidosis within the clinical picture of multiple sclerosis?]. 152 36

Observation of neurosarcoidosis in a thirty-year-old black female characterised predominantly by bilateral facial nerve paralysis gave rise to a review of literature since 1978 and also to a comparison with an early study in 1963. As described 1963 the clinical picture is characterized by increased protein content of the CSF (33.8%), facial nerve paresis (25.5%), pleocytosis (23%), diabetes insipidus (21%), hemiparesis (17.2%), organic psychosis (16.9%), papilloedema (15.5%), ataxia (13%), convulsive seizures (12.5%), optic atrophy (12.5%), loss of hearing (12.2%), nystagmus (8.6%) and numerous other symptoms more rarely found. This corresponds to the symptoms of chronic basal meningitis with an infiltration in the neighbouring structures of brain and less frequently the spinal cord. In only 58.7% of the cases (presumably at the onset of sarcoidosis) was the bronchial tract (or the lungs) affected, in 11.5% the skin or the eyes. Although the clinical picture is clear enough the etiology has yet to be determined. Evidence of a pathogen or a pathogenic agent (analogous to berylliosis) has never been established to date. On the other hand there are some indications of a disturbance in the immune system, perhaps of a particular genetic foundation since sarcoidosis strikes black patients with conspicuous frequency. There exist more cases in one family. Exceeding expected random distribution, many patients have the HLA-Factor B 8 (on the chromosome 6) and DR 3. The Kveim-Test was in 71 cases positive, in 12 cases negative. The possibilities of carrying out studies of CSF - analogous to the studies of bronchial lavage - in the most cases of neurosarcoidosis have not been exhausted as to determine the activity of the T-lymphocytes, the interleucines, the angiotensin-converting enzyme while the Gallium 67 scintigraphy and other methods to determine the non-specific activity of the inflammation. The efficiency of the treatment with corticosteroids (Prednison or Triamcinolonacetonid) depends of the phase of the inflammatory process. 12% of the registered cases died.
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PMID:[Neurosarcoidosis. Comparative analysis of the clinical profile based on 537 cases from the world literature up to 1963 and from 1976-1988]. 240 26

Visual and brainstem auditory evoked potentials (VEPs, BAEPs) were recorded in 23 patients with neurosarcoidosis. Eight patients (35%) had abnormal BAEPs, and 10 (43%) had abnormal VEPs. Four of the 8 patients with abnormal BAEPs had facial paresis, one had impaired memory and only 3 had symptoms and signs compatible with brainstem lesion. Seven of the patients with abnormal VEPs had no visual symptoms. These findings suggest that BAEP and VEP can reveal subclinical nervous system involvement in sarcoidosis and can also help in the early diagnosis of neurosarcoidosis. Successive recordings of 5 patients showed that BAEP and VEP were useful in the follow-up of these patients.
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PMID:Visual and auditory evoked potentials in the early diagnosis and follow-up of neurosarcoidosis. 302 Aug 57

Fifty consecutive patients with neurosarcoidosis were evaluated retrospectively. Sarcoidosis presented first with neurologic signs in 24 patients (48%), but systemic symptoms developed later in all but five. Main neurologic involvements were central nervous system lesions in 33 patients (66%), cranial nerve paresis in 12 (24%), and peripheral nerve lesions in five patients (10%). Seventeen patients (34%) had more than one type of neurologic involvement. Routine cerebrospinal fluid (CSF) parameters showed unspecific abnormalities in 35 patients (70%). CSF angiotensin converting enzyme was elevated in 18 of 31 patients (58%). Brain computerized tomography was abnormal in 13 of 32 patients (41%). Visual and brainstem evoked potentials were abnormal in ten (43%) and eight (35%) of 23 patients, respectively, suggesting subclinical lesions in 13 patients. Neurologic signs improved in 24 patients (48%), were stable in 11 (22%), and progressed in 15 patients (30%). Six patients died. Cranial nerve lesions improved most often. Course of neurologic involvements was similar in acute or subacute and chronic sarcoidosis. The effect of steroid treatment was inconsistent.
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PMID:Neurosarcoidosis: clinical presentations and course in 50 patients. 371 68

The association of multiple non-caseating granulomata and a positive Kviem test is normally considered to be indicative of a diagnosis of sarcoidosis. However, although depressed cell-mediated immunity is commonly described, it is extremely rare to find a humoral immune paresis. A patient is reported who had multiple granulomata, depressed cellular and humoral immunity and a positive Kveim test.
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PMID:Sarcoidosis associated with combined immunodeficiency. 743 28

The patient was a 20-year-old female who complained of hoarseness and dysphagia. Chest X-ray showed bilateral hilar lymphadenopathy. Sarcoidosis was diagnosed histologically on the basis of granuloma without necrosis, by transbronchial lung biopsy (TBLB). Bronchofiberscopic findings revealed no granuloma of the vocal cords. Examination of the central nervous system with MRI identified no abnormalities. Hoarseness and dysphagia were thought to have been caused by glossopharyngeal and vagus nerve paresis. These signs improved markedly after two weeks of steroid therapy. This is a rare case of sarcoidosis associated with glossopharyngeal & vagus nerve paresis.
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PMID:[A case of sarcoidosis presenting with hoarseness and dysphagia due to glossopharyngeal and vagus nerve paresis]. 808 51

Neurosarcoidosis mimicking CNS tumours represents a rare manifestation of Schaumann's disease. The central or peripheral nervous system is clinically involved in 5% of sarcoidosis, basal parts of the brain being mainly affected by the inflammation. This location of the process causes basal meningitis with cranial nerve paresis as well as parenchymal granulomatosis around the third ventricle and hypophysis. Solid, space-occupying lesions rarely occur, evoking problems in the differentiation from cerebral tumours. We report three cases of neurosarcoidosis presenting as intracranial tumours, where a space-occupying lesion was the first of only manifestation of sarcoidosis. The lesions in our cases were found in parietal and parieto-occipital cortex and in the fourth ventricle and vermis cerebelli, respectively. These locations are unusual, since most of the reported cases were affecting the temporal lobe. We review the literature and discuss the role of neurosarcoidosis in the differential diagnosis of intracranial tumours.
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PMID:[Tumorous neurosarcoidosis--a rare manifestation of Boeck disease--3 cases and review of the literature]. 890 Aug 98

We report two siblings with sarcoidosis; the younger sister had symptoms of central nervous system, and both sisters had subcutaneous mass lesions in the gluteal region. Case 1. A 30-year-old woman presented with two episodes of right leg paresis. On admission, neurological examination revealed right leg weakness, spasticity of both legs, increased deep tendon reflexes in all extremities, urinary disturbance and hearing loss of the right ear, but she had no meningeal signs. Serological studies were normal including angiotensin converting enzyme. Cerebrospinal fluid revealed elevated protein to 340 mg/dl, mild pleocytosis, decreased glucose. CSF culture was negative, and cytology showed no malignant cells. Enhanced MR imaging showed diffuse leptomeningeal enhancement in both the brain around basal meninges and the whole spinal cord. Case 2. A 34-year-old woman (the elder sister of Case 1) presented with visual disturbance. She had been diagnosed to have bilateral iritis at Hiroshima Red Cross Hospital before visiting our hospital. Neurological examination and serological studies were normal. In both cases, left gluteal subcutaneous mass was detected and its biopsy revealed characteristic sarcoid nodules and confirmed the diagnosis of sarcoidosis. A tendency of familial occurrence and positive associations of the specific HLA antigens in sarcoidosis have been reported. Though the diagnosis of neurosarcoidosis has been difficult without extraneurological signs, sarcoidosis should be considered as a differential diagnosis in all the patients with myelopathy, and enhanced MRI and measure of CSF angiotensin converting enzyme seem to be useful for diagnosis and evaluation of drug effect during the course of steroid therapy.
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PMID:[Two siblings with sarcoidosis diagnosed by younger sister's central nervous symptoms]. 904 58


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