Systemic sarcoidosis with neurosarcoidosis revealed by central diabetes insipidus

Neurological involvement in sarcoidosis is rare, often indicative of the disease, and may be the only involvement. It can affect the central or peripheral nervous system or the cranial nerves. This is a 28-year-old female patient with no particular medical history who consulted for bilateral rhinorrhea and intermittent nasal obstruction that had been developing for 8 months, associated with stage 1 mMRC dyspnea and spaniomenorrhea, developing in a context of apyrexia and preservation of general condition. Clinical examination revealed cervical lymphadenopathy associated with a subcutaneous nodule on the left arm, with chest CT showing bilateral mediastinal and hilar lymphadenopathy. Staged bronchial, labial, nasopharyngeal, and skin biopsies were consistent with tuberculoid granuloma without caseous necrosis. Pituitary MRI showed typical neurosarcoidosis involvement revealed by central diabetes insipidus, and a diagnosis of neurosarcoidosis was made.