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Small-vessel vasculitis

 

Differentiation between neurosarcoidosis and primary central nervous system vasculitis based on demographic, cerebrospinal and imaging features


1, 2, 3, 4, 5, 6, 7

 

  1. Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  2. Department of Neuroradiology, Cleveland Clinic, Cleveland, OH, USA.
  3. Department of Diagnostic Radiology, University Hospitals Parma Medical Center
  4. Department of Rheumatology, Cleveland Clinic, Cleveland, OH, USA.
  5. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
  6. Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
  7. Department of Rheumatology, Cleveland Clinic, Cleveland, OH, USA. hajjalr@ccf.org

CER12230
2020 Vol.38, N°2 ,Suppl.124
PI 0135, PF 0138
Small-vessel vasculitis

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PMID: 31928590 [PubMed]

Received: 13/03/2019
Accepted : 08/07/2019
In Press: 07/01/2020
Published: 21/05/2020

Abstract

OBJECTIVES. Neurosarcoidosis (NS) and primary angiitis of central nervous system (PACNS) are inflammatory diseases affecting central nervous system, with overlapping clinical and pathological characteristics. Distinguishing these diseases is important given distinct therapeutic implications. In this study, we aimed to compare demographic, CSF and MRI characteristics between these two conditions. METHODS. All the clinical, CSF and laboratory characteristics at the time of presentation were retrieved from electronic medical records. Brain and/or spinal cord MRI performed near the time of presentation were blindly evaluated by two neuroradiologists. Data regarding involvement of pachy- and leptomeninges, basal meninges, cranial nerves, cerebral grey and white matter, and spinal cord were recorded for each patient. RESULTS. 78 patients with PACNS and 25 patients with NS were included in the study. Mean age of patients was 43.7 (±16.7) and 43.6 (±12.5) in PACNS and NS, respectively. African-American race was found to be associated with the diagnosis of NS rather than PACNS. Patients with PACNS had higher frequency of cerebral involvement, while patients with NS demonstrated more frequent spinal cord, basal meningeal and cranial nerve involvements. CONCLUSIONS. These findings suggest that MRI can be an efficient tool in distinguishing PACNS from NS. A follow-up study with a larger sample size would be required to validate our results.

Rheumatology Article