• Rev Med Interne · Oct 2004

    Case Reports

    [Bilateral optic neuropathy revealing systemic sarcoidosis].

    • P Guilpain, M A Andreu, N Cassoux, D Le Thi Huong-Boutin, F Jaeger-Bizet, X Nasica, C Chapelon-Abric, B Wechsler, P Lehoang, and J C Piette.
    • Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France. pguilpain@wanadoo.fr
    • Rev Med Interne. 2004 Oct 1; 25 (10): 755-8.

    IntroductionAlthough ocular involvement concerns about 25 to 60% of patients with systemic sarcoidosis, papilledema is a rare event.ExegesisA 43-year-old man presented with left visual loss related to papillitis. Despite high-dose corticosteroids, visual loss became rapidly bilateral. Thoracic CT-scan showed mediastinal and parenchymal involvement. Histological study of lung, bronchial and lymphadenopathy biopsies displayed giant-cells granuloma without necrosis. Diagnosis of sarcoidosis complicated with optic neuropathy was made. Therapy combining prednisone, methotrexate and infliximab was started without significant improvement of visual acuity.ConclusionThis report underlines the potential severity of optic neuropathy in sarcoidosis.

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