Infliximab for relapsing neurosarcoidosis recurring after kidney transplantation: a case report

Acta Clin Belg. 2021 Apr;76(2):149-151. doi: 10.1080/17843286.2019.1664093. Epub 2019 Sep 5.

Abstract

Neurological involvement of sarcoidosis is a rare condition, and its occurrence in the context of transplantation is exceptional. Moreover, treatment can be challenging. We report the unusual case of a patient transplanted with a kidney for end-stage renal disease secondary to sarcoidosis who experienced a neurological recurrence of the disease under immunosuppressive treatment, translating in behavioural aggressiveness, social withdrawal and weight loss. He relapsed thrice under corticosteroids but responded finally to infliximab. This case highlights the potential of sarcoidosis to recur neurologically after kidney transplantation despite immunosuppressive treatment. Also, treatment of relapsing neurosarcoidosis can be challenging and may benefit from TNF-α blockers.

Keywords: Neurosarcoidosis; TNF-alpha blockers; immunosuppression; kidney transplantation; sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Central Nervous System Diseases
  • Humans
  • Infliximab / therapeutic use
  • Kidney Transplantation* / adverse effects
  • Male
  • Neoplasm Recurrence, Local
  • Sarcoidosis* / drug therapy

Substances

  • Infliximab

Supplementary concepts

  • Neurosarcoidosis