Journal
RESPIRATORY MEDICINE
Volume 103, Issue 2, Pages 268-273Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.rmed.2008.08.016
Keywords
Sarcoidosis; Neurosarcoidosis; Tumor necrosis factor; Infliximab; Cyclophosphamide; Central nervous system
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Central nervous system involvement is a severe manifestation of sarcoidosis that often requires aggressive immunosuppressive therapy. The most efficacious approach for refractory disease is unknown. We reviewed the cases of four subjects who demonstrated active progression of neurosarcoidosis white under treatment with cyclophosphamide, and who were subsequently treated with infliximab. All four subjects demonstrated rapid and substantial reversal, of their clinical. course. Radiologic findings were concordant with the clinical responses. There were no notable toxicities. Treatment with infliximab may be more effective than cyclophosphamide for refractory central nervous system sarcoidosis. A larger, prospective study is warranted. (C) 2008 Elsevier Ltd. All rights reserved.
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