Conjunctival biopsy to diagnose neurosarcoidosis in patients with inflammatory nervous system disease of unknown etiology

Michael R. Pichler, Eoin Flanagan, Allen Jr. Aksamit, Jacqueline A. Leavitt, Diva R. Salomaõ, B Mark Keegan

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Summary Neurosarcoidosis mimics many neurologic diseases and poses a major diagnostic challenge. Blind conjunctival biopsy is often used to help diagnose neurosarcoidosis when biopsy of affected nervous system tissue is not feasible. While this test is relatively inexpensive and well-tolerated, the diagnostic yield in patients with inflammatory nervous system disease of unknown etiology remained uncertain. We evaluated 440 patients who underwent conjunctival biopsy due to concern for neurosarcoidosis. Only a small minority of patients (3%) had positive conjunctival biopsies consistent with sarcoidosis, and some patients (1%) with positive biopsies were found to have a cause for their neurologic disease other than neurosarcoidosis. Many patients (14%) had negative conjunctival biopsies but were later confirmed to have neurosarcoidosis after additional evaluations. This study demonstrates that conjunctival biopsy has a low diagnostic yield for neurosarcoidosis in patients with inflammatory nervous system disease and suggests that alternative diagnostic means should be pursued.

Original languageEnglish (US)
Pages (from-to)216-223
Number of pages8
JournalNeurology: Clinical Practice
Volume5
Issue number3
DOIs
StatePublished - Jun 10 2015

Fingerprint

Nervous System Diseases
Biopsy
Nerve Tissue
Sarcoidosis
Neurosarcoidosis
Nervous System

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Conjunctival biopsy to diagnose neurosarcoidosis in patients with inflammatory nervous system disease of unknown etiology. / Pichler, Michael R.; Flanagan, Eoin; Aksamit, Allen Jr.; Leavitt, Jacqueline A.; Salomaõ, Diva R.; Keegan, B Mark.

In: Neurology: Clinical Practice, Vol. 5, No. 3, 10.06.2015, p. 216-223.

Research output: Contribution to journalArticle

@article{7ae6cb9c86e64530b9670dc0d08ec799,
title = "Conjunctival biopsy to diagnose neurosarcoidosis in patients with inflammatory nervous system disease of unknown etiology",
abstract = "Summary Neurosarcoidosis mimics many neurologic diseases and poses a major diagnostic challenge. Blind conjunctival biopsy is often used to help diagnose neurosarcoidosis when biopsy of affected nervous system tissue is not feasible. While this test is relatively inexpensive and well-tolerated, the diagnostic yield in patients with inflammatory nervous system disease of unknown etiology remained uncertain. We evaluated 440 patients who underwent conjunctival biopsy due to concern for neurosarcoidosis. Only a small minority of patients (3{\%}) had positive conjunctival biopsies consistent with sarcoidosis, and some patients (1{\%}) with positive biopsies were found to have a cause for their neurologic disease other than neurosarcoidosis. Many patients (14{\%}) had negative conjunctival biopsies but were later confirmed to have neurosarcoidosis after additional evaluations. This study demonstrates that conjunctival biopsy has a low diagnostic yield for neurosarcoidosis in patients with inflammatory nervous system disease and suggests that alternative diagnostic means should be pursued.",
author = "Pichler, {Michael R.} and Eoin Flanagan and Aksamit, {Allen Jr.} and Leavitt, {Jacqueline A.} and Saloma{\~o}, {Diva R.} and Keegan, {B Mark}",
year = "2015",
month = "6",
day = "10",
doi = "10.1212/CPJ.0000000000000133",
language = "English (US)",
volume = "5",
pages = "216--223",
journal = "Neurology: Clinical Practice",
issn = "2163-0402",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Conjunctival biopsy to diagnose neurosarcoidosis in patients with inflammatory nervous system disease of unknown etiology

AU - Pichler, Michael R.

AU - Flanagan, Eoin

AU - Aksamit, Allen Jr.

AU - Leavitt, Jacqueline A.

AU - Salomaõ, Diva R.

AU - Keegan, B Mark

PY - 2015/6/10

Y1 - 2015/6/10

N2 - Summary Neurosarcoidosis mimics many neurologic diseases and poses a major diagnostic challenge. Blind conjunctival biopsy is often used to help diagnose neurosarcoidosis when biopsy of affected nervous system tissue is not feasible. While this test is relatively inexpensive and well-tolerated, the diagnostic yield in patients with inflammatory nervous system disease of unknown etiology remained uncertain. We evaluated 440 patients who underwent conjunctival biopsy due to concern for neurosarcoidosis. Only a small minority of patients (3%) had positive conjunctival biopsies consistent with sarcoidosis, and some patients (1%) with positive biopsies were found to have a cause for their neurologic disease other than neurosarcoidosis. Many patients (14%) had negative conjunctival biopsies but were later confirmed to have neurosarcoidosis after additional evaluations. This study demonstrates that conjunctival biopsy has a low diagnostic yield for neurosarcoidosis in patients with inflammatory nervous system disease and suggests that alternative diagnostic means should be pursued.

AB - Summary Neurosarcoidosis mimics many neurologic diseases and poses a major diagnostic challenge. Blind conjunctival biopsy is often used to help diagnose neurosarcoidosis when biopsy of affected nervous system tissue is not feasible. While this test is relatively inexpensive and well-tolerated, the diagnostic yield in patients with inflammatory nervous system disease of unknown etiology remained uncertain. We evaluated 440 patients who underwent conjunctival biopsy due to concern for neurosarcoidosis. Only a small minority of patients (3%) had positive conjunctival biopsies consistent with sarcoidosis, and some patients (1%) with positive biopsies were found to have a cause for their neurologic disease other than neurosarcoidosis. Many patients (14%) had negative conjunctival biopsies but were later confirmed to have neurosarcoidosis after additional evaluations. This study demonstrates that conjunctival biopsy has a low diagnostic yield for neurosarcoidosis in patients with inflammatory nervous system disease and suggests that alternative diagnostic means should be pursued.

UR - http://www.scopus.com/inward/record.url?scp=84930726375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930726375&partnerID=8YFLogxK

U2 - 10.1212/CPJ.0000000000000133

DO - 10.1212/CPJ.0000000000000133

M3 - Article

AN - SCOPUS:84930726375

VL - 5

SP - 216

EP - 223

JO - Neurology: Clinical Practice

JF - Neurology: Clinical Practice

SN - 2163-0402

IS - 3

ER -