PT  - JOURNAL ARTICLE
AU  - Lord, Jennifer
AU  - Paz Soldan, M. Mateo
AU  - Galli, Jonathan
AU  - Salzman, Karen L.
AU  - Kresser, Jacob
AU  - Bacharach, Rae
AU  - DeWitt, L. Dana
AU  - Klein, Julia
AU  - Rose, John
AU  - Greenlee, John
AU  - Clardy, Stacey L.
TI  - Neurosarcoidosis
AID  - 10.1212/NXI.0000000000000743
DP  - 2020 Jul 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e743
VI  - 7
IP  - 4
4099  - http://nn.neurology.org/content/7/4/e743.short
4100  - http://nn.neurology.org/content/7/4/e743.full
SO  - Neurol Neuroimmunol Neuroinflamm2020 Jul 01; 7
AB  - Objective To characterize patients with neurosarcoidosis within the University of Utah healthcare system, including demographics, clinical characteristics, treatment, and long-term outcomes.Methods We describe the clinical features and outcomes of patients with neurosarcoidosis within the University of Utah healthcare system (a large referral center for 10% of the continental United States by land mass). Patients were selected who met the following criteria: (1) at least one International Classification of Diseases Clinical Modification, 9th revision code 135 or International Classification of Diseases Clinical Modification, 10th revision code D86* (sarcoidosis) and (2) at least one outpatient visit with a University of Utah clinician in the Neurology Department within the University of Utah electronic health record.Results We identified 56 patients meeting the study criteria. Thirty-five patients (63%) were women, and most patients (84%) were white. Twelve patients (22%) met the criteria for definite neurosarcoidosis, 36 patients (64%) were diagnosed with probable neurosarcoidosis, and 8 patients (14%) were diagnosed with possible neurosarcoidosis. A total of 8 medications were used for the treatment of neurosarcoidosis. Prednisone was the first-line treatment in 51 patients (91%). Infliximab was the most effective therapy, with 87% of patients remaining stable or improving on infliximab. Treatment response for methotrexate and azathioprine was mixed, and mycophenolate mofetil and rituximab were the least effective treatments in this cohort.Conclusions This is a comprehensive characterization of neurosarcoidosis within a single healthcare system at the University of Utah that reports long-term response to treatment and outcomes of patients with neurosarcoidosis. Our results suggest the use of infliximab as a first-line therapy for neurosarcoidosis.ACE=angiotensin-converting enzyme; CVID=common variable immune deficiency; PNS=peripheral nervous system; TNFα=tumor necrosis factor-alpha