Neurosarcoïdose en paraneurosarcoïdose

• The clinical spectrum of neurosarcoidosis is highly diverse; virtually any neurological syndrome can present, depending upon granuloma localization.
• There are indications that neurosarcoidosis is insufficiently recognized as a separate clinical entity. In the absence of major prospective clinical trials, we launched a large national online registry of neurosarcoidosis patients in the Netherlands in June 2014 at www.neurosarcoidose.nl.
• When a patient with sarcoidosis presents with neurological symptoms that may compatible with sarcoidosis, it is important to locate sites of disease activity accessible for biopsy outside the nervous system.
• Small nerve fibre neuropathy is a common neurological complication of sarcoidosis. It is considered an epiphenomenon, and therefore classified as 'para-neurosarcoidosis'.
• Neurological symptoms causing disability are an indication for immunosuppressive therapy.
• There is increasing evidence for the effective treatment of refractory neurosarcoidosis using biologicals.
• Whether the intravenous administration of immunoglobulins or ARA290, an erythropoietin derivative with TNF-α-antagonistic and tissue-protective characteristics, is effective for small nerve fibre neuropathy in sarcoidosis is subject for study.

Conflict of interest and financial support for this article: M.R. Tannemaat is a member of the scientific advisory board of Araim Pharmaceuticals; E. Hoitsma has received grants from Astellas and the Netherlands sarcoidosis patient society (Sarcoïdose Belangenvereniging Nederland), and non-financial support from Curavista.