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dc.rights.licenseopenen_US
dc.contributor.authorBEKKOUR, I.
dc.contributor.authorCOURTIN, E.
dc.contributor.authorDULAU-METRAS, C.
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
dc.contributor.authorDUFFAU, Pierre
dc.contributor.authorKREMER, L.
dc.contributor.authorMATHEY, G.
dc.date.accessioned2024-09-26T13:12:22Z
dc.date.available2024-09-26T13:12:22Z
dc.date.issued2023
dc.identifier.issn1756-2856en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/201843
dc.description.abstractEnBackground: Neurosarcoidosis is a rare manifestation of sarcoidosis with heterogeneous presentations. Patient management is challenging due to the current lack of knowledge about the long-term disease course. Objective: To identify specific disease courses of neurosarcoidosis according to the clinical and paraclinical presentations at onset. Methods: We conducted an observational multicenter cohort study by retrospectively collecting data from the medical records of 84 patients diagnosed with definite, probable, or possible neurosarcoidosis in three tertiary referral centers in France (Nancy, Strasbourg, and Bordeaux). We collected demographic characteristics, clinical and paraclinical data at the beginning of patient management, and during follow-up under the different treatment lines. Two expert neurologists determined disease course profiles. Results: The mean follow-up was 6.6 years. Almost every patient (96.4%) received steroids at some point of their follow-up. Tumor Necrosis Factor-alpha blockers were given in 10.7% as first-line treatment and in 33.3% during follow-up. Every patient presented with a relapsing disease, often monophasic (75%) and sometimes polyphasic with the recurrence of identical manifestations (11.9%). Patients developing new neurological symptoms during follow-up were a minority (13.1%). No patients exhibited a progressive course. Patients with isolated cranial nerves injury or aseptic meningitis always exhibited a monophasic course, and 62.5–75% of them had a full recovery after first-line treatments. This proportion was 15.6% in other forms of the disease. Those with peripheral presentations were more likely to present a polyphasic course than patients with other forms of neurosarcoidosis. Spinal cord presentations were monophasic, but resulted in sequelae and exhibited poor response to first-line treatments despite frequent use of TNF-alpha blockers. Conclusion: Identification of these disease course profiles, based on the initial clinical and paraclinical presentation, could guide the clinician to select the optimal therapeutic approach and follow-up modalities for their patients with neurosarcoidosis.
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/3.0/us/*
dc.subject.enCohort
dc.subject.enDisease course
dc.subject.enDisease modifying treatments
dc.subject.enNeurosarcoidosis
dc.subject.enLong term
dc.title.enDefining the course of neurosarcoidosis according to presentation at onset and disease modifying treatment: a cohort study of 84 patients
dc.typeArticle de revueen_US
dc.identifier.doi10.1177/17562864231205954en_US
dc.identifier.pubmed38143513en_US
bordeaux.journalTherapeutic Advances in Neurological Disordersen_US
bordeaux.volume16en_US
bordeaux.hal.laboratoriesImmunoConcEpT - UMR 5164en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
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hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccCC BY-NCen_US
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