Neurosarcoidosis: guidance for the general neurologist

Detalhes bibliográficos
Autor(a) principal: Dutra, Lívia Almeida [UNIFESP]
Data de Publicação: 2012
Outros Autores: Braga-neto, Pedro [UNIFESP], Oliveira, Ricardo Araújo [UNIFESP], Pedroso, José Luiz [UNIFESP], Abrahão, Agessandro [UNIFESP], Barsottini, Orlando Graziani Povoas [UNIFESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S0004-282X2012000400014
http://repositorio.unifesp.br/handle/11600/7045
Resumo: Neurosarcoidosis (NS) more commonly occurs in the setting of systemic disease. The diagnosis is based on a clinical history suggestive of NS, presence of noncaseating granulomas, and supportive evidence of sarcoid pathology, laboratory, and imaging studies. NS could involve any part of the nervous system and often demands high doses of steroids for symptom control. It presents low response to isolated steroids administration and frequently requires immunosuppressive agents. In NS, lymphocytes are polarized toward an excessive Th1 response, leading to overproduction of TNF-alpha and INF-gama, as well as lL-2 and IL-15. Infliximab, a chimeric monoclonal antibody that neutralizes the biological activity of TNF-alpha, is a new option in the NS treatment. We revised pathophysiology, clinical manifestations, diagnostic work up, and treatment of NS as guidance for the general neurologist.
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spelling Neurosarcoidosis: guidance for the general neurologistNeurosarcoidose: orientações para o neurologista geralsarcoidosisneurosarcoidosismethotrexateazathioprinecyclophosphamideinfliximabsarcoidoseneurosarcoidosemetotrexatoazatioprinaciclofosfamidainfliximabeNeurosarcoidosis (NS) more commonly occurs in the setting of systemic disease. The diagnosis is based on a clinical history suggestive of NS, presence of noncaseating granulomas, and supportive evidence of sarcoid pathology, laboratory, and imaging studies. NS could involve any part of the nervous system and often demands high doses of steroids for symptom control. It presents low response to isolated steroids administration and frequently requires immunosuppressive agents. In NS, lymphocytes are polarized toward an excessive Th1 response, leading to overproduction of TNF-alpha and INF-gama, as well as lL-2 and IL-15. Infliximab, a chimeric monoclonal antibody that neutralizes the biological activity of TNF-alpha, is a new option in the NS treatment. We revised pathophysiology, clinical manifestations, diagnostic work up, and treatment of NS as guidance for the general neurologist.A neurosarcoidose (NS) ocorre frequentemente no contexto de doença sistêmica. O diagnóstico é baseado na história clínica sugestiva de NS, presença de granulomas não-caseosos e achados anatomopatológicos, laboratoriais e radiológicos de sarcoidose. A NS causa manifestações neurológicas variadas, que apresentam, em geral, baixa resposta ao corticoide isoladamente e, portanto, necessitam uso de imunossupressores. Na NS, os linfócitos estão polarizados para resposta Th1 excessiva, levando à produção aumentada de TNF-alfa e IFN-gama, assim como IL-2 e IL-15. Infliximabe, um anticorpo monoclonal quimérico que neutraliza a atividade biológica do TNF-alfa, é uma nova opção no tratamento da NS. Revisou-se a fisiopatologia, as manifestações clínicas, o diagnóstico e o tratamento da NS para orientar neurologistas gerais.Universidade Federal de São Paulo (UNIFESP) Department of Neurology and Neurosurgery Division of General NeurologyUNIFESP, Department of Neurology and Neurosurgery Division of General NeurologySciELOAcademia Brasileira de Neurologia - ABNEUROUniversidade Federal de São Paulo (UNIFESP)Dutra, Lívia Almeida [UNIFESP]Braga-neto, Pedro [UNIFESP]Oliveira, Ricardo Araújo [UNIFESP]Pedroso, José Luiz [UNIFESP]Abrahão, Agessandro [UNIFESP]Barsottini, Orlando Graziani Povoas [UNIFESP]2015-06-14T13:43:41Z2015-06-14T13:43:41Z2012-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion293-299application/pdfhttp://dx.doi.org/10.1590/S0004-282X2012000400014Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 70, n. 4, p. 293-299, 2012.10.1590/S0004-282X2012000400014S0004-282X2012000400014.pdf0004-282XS0004-282X2012000400014http://repositorio.unifesp.br/handle/11600/7045WOS:000302889200014engArquivos de Neuro-Psiquiatriainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-29T00:32:21Zoai:repositorio.unifesp.br/:11600/7045Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-29T00:32:21Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Neurosarcoidosis: guidance for the general neurologist
Neurosarcoidose: orientações para o neurologista geral
title Neurosarcoidosis: guidance for the general neurologist
spellingShingle Neurosarcoidosis: guidance for the general neurologist
Dutra, Lívia Almeida [UNIFESP]
sarcoidosis
neurosarcoidosis
methotrexate
azathioprine
cyclophosphamide
infliximab
sarcoidose
neurosarcoidose
metotrexato
azatioprina
ciclofosfamida
infliximabe
title_short Neurosarcoidosis: guidance for the general neurologist
title_full Neurosarcoidosis: guidance for the general neurologist
title_fullStr Neurosarcoidosis: guidance for the general neurologist
title_full_unstemmed Neurosarcoidosis: guidance for the general neurologist
title_sort Neurosarcoidosis: guidance for the general neurologist
author Dutra, Lívia Almeida [UNIFESP]
author_facet Dutra, Lívia Almeida [UNIFESP]
Braga-neto, Pedro [UNIFESP]
Oliveira, Ricardo Araújo [UNIFESP]
Pedroso, José Luiz [UNIFESP]
Abrahão, Agessandro [UNIFESP]
Barsottini, Orlando Graziani Povoas [UNIFESP]
author_role author
author2 Braga-neto, Pedro [UNIFESP]
Oliveira, Ricardo Araújo [UNIFESP]
Pedroso, José Luiz [UNIFESP]
Abrahão, Agessandro [UNIFESP]
Barsottini, Orlando Graziani Povoas [UNIFESP]
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Dutra, Lívia Almeida [UNIFESP]
Braga-neto, Pedro [UNIFESP]
Oliveira, Ricardo Araújo [UNIFESP]
Pedroso, José Luiz [UNIFESP]
Abrahão, Agessandro [UNIFESP]
Barsottini, Orlando Graziani Povoas [UNIFESP]
dc.subject.por.fl_str_mv sarcoidosis
neurosarcoidosis
methotrexate
azathioprine
cyclophosphamide
infliximab
sarcoidose
neurosarcoidose
metotrexato
azatioprina
ciclofosfamida
infliximabe
topic sarcoidosis
neurosarcoidosis
methotrexate
azathioprine
cyclophosphamide
infliximab
sarcoidose
neurosarcoidose
metotrexato
azatioprina
ciclofosfamida
infliximabe
description Neurosarcoidosis (NS) more commonly occurs in the setting of systemic disease. The diagnosis is based on a clinical history suggestive of NS, presence of noncaseating granulomas, and supportive evidence of sarcoid pathology, laboratory, and imaging studies. NS could involve any part of the nervous system and often demands high doses of steroids for symptom control. It presents low response to isolated steroids administration and frequently requires immunosuppressive agents. In NS, lymphocytes are polarized toward an excessive Th1 response, leading to overproduction of TNF-alpha and INF-gama, as well as lL-2 and IL-15. Infliximab, a chimeric monoclonal antibody that neutralizes the biological activity of TNF-alpha, is a new option in the NS treatment. We revised pathophysiology, clinical manifestations, diagnostic work up, and treatment of NS as guidance for the general neurologist.
publishDate 2012
dc.date.none.fl_str_mv 2012-04-01
2015-06-14T13:43:41Z
2015-06-14T13:43:41Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0004-282X2012000400014
Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 70, n. 4, p. 293-299, 2012.
10.1590/S0004-282X2012000400014
S0004-282X2012000400014.pdf
0004-282X
S0004-282X2012000400014
http://repositorio.unifesp.br/handle/11600/7045
WOS:000302889200014
url http://dx.doi.org/10.1590/S0004-282X2012000400014
http://repositorio.unifesp.br/handle/11600/7045
identifier_str_mv Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 70, n. 4, p. 293-299, 2012.
10.1590/S0004-282X2012000400014
S0004-282X2012000400014.pdf
0004-282X
S0004-282X2012000400014
WOS:000302889200014
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Arquivos de Neuro-Psiquiatria
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 293-299
application/pdf
dc.publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
_version_ 1814268458735501312

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