The use of cladribine in neurosarcoidosis: A report of two cases

Abstract

Sarcoidosis is a chronic inflammatory multisystem disorder haracterized by the development of non-caseating granuloas. Neurological complications occur in 5–15% of patients with ystemic sarcoidosis and can lead to significant neurological mpairment and disability [1]. Sarcoidosis can affect various elements of the neural axis, ausing cranial neuropathies, aseptic meningitis, meningeal mass esions, brain and spinal cord parenchymal lesions, intracranial vasulopathies, peripheral neuropathies and myopathies. Due to its ariable clinical manifestations, diagnosis is often problematic and elayed, impacting unfavourably on disease outcomes. Prognosis is ariable, depending on duration and extent of disease, and response o treatment [1]. There are no established treatment guidelines for neurosaroidosis. However, corticosteroids are generally accepted as first ine therapy. In the event of corticosteroid failure or adverse effects, umerous alternative immunosuppressive therapies have been ecommended with variable response [1]. We report two cases of eurosarcoidosis that showed a remarkable clinical and radiologial response to the use of the chemotherapeutic agent, cladribine.