Bilateral Lumbosacral Plexopathy As the Initial Manifestation of Systemic Sarcoidosis: A Case Report

TL;DR

A rare case of systemic sarcoidosis initially presenting as bilateral lumbosacral plexopathy is reported, highlighting the importance of early diagnosis to prevent neurological damage.

Contribution

This case report adds to the limited literature on lumbosacral plexopathy as an initial manifestation of systemic sarcoidosis.

Findings

Bilateral lumbosacral plexopathy can be the initial sign of systemic sarcoidosis.

Prompt recognition and treatment may prevent irreversible neurological impairment.

The case highlights the need for considering sarcoidosis in the differential diagnosis of plexopathy.

Abstract

Neurosarcoidosis is one of the most relevant involvements in systemic sarcoidosis and can be the initial presentation. Its diagnosis is often considered difficult because of unusual clinical manifestations or diagnostic mimics. The peripheral nervous system is less frequently involved than the central nervous system, although it may also lead to irreversible neurologic impairment. Lumbosacral plexopathy in sarcoidosis is a rare presentation and has been scarcely described in anecdotal case reports and small case series.

We describe the case of a 61-year-old female who presented with right inguinal pain, right thigh weakness, and gait limitation, with imaging evidence of bilateral lumbosacral plexopathy as the initial manifestation of systemic sarcoidosis and subsequently developed joint and pulmonary involvement.

This case report aims to bring awareness of this involvement as a possible initial manifestation of systemic sarcoidosis and mention key features of the differential diagnosis. Prompt recognition and treatment may prevent neurologic impairment.

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