Abstract

To the Editor:

Sarcoidosis is a multisystem granulomatous disease that can involve any part of the nervous system. About 5 to 15% of patients with sarcoidosis will have clinical involvement of the nervous system. Neurologic features of sarcoidosis are nonspecific and include cranial neuropathy, aseptic meningitis, increased intracranial pressure, hydrocephalus, mass lesions, white matter disease, and peripheral neuropathy. Cerebrospinal fluid (CSF) abnormalities are nonspecific. We describe a patient with active pulmonary sarcoidosis that developed neurologic symptoms. Although neurosarcoidosis was felt to be the diagnosis, clinical and cerebral imaging showed progression of disease on prednisone and methotrexate therapy. A brain biopsy showed glioblastoma multiform.