A case report of neurosarcoidosis mimicking Guillain-Barré syndrome: the diagnostic utility of skin biopsy in neurosarcoidosis

TL;DR

A 74-year-old woman's case of neurosarcoidosis was initially mistaken for Guillain-Barré syndrome, but a skin biopsy helped confirm the correct diagnosis.

Contribution

Demonstrates the diagnostic value of skin biopsy in atypical neurosarcoidosis cases resembling Guillain-Barré syndrome.

Findings

The patient's symptoms initially mimicked Guillain-Barré syndrome but later relapsed.

A skin biopsy provided crucial histological evidence for diagnosing neurosarcoidosis.

The case underscores the need for systemic evaluation in atypical neurological presentations.

Abstract

We report a compelling case of neurosarcoidosis in a 74-year-old Japanese woman. She initially presented with a clinical course that closely mimicked Guillain-Barré syndrome (GBS), and the definitive diagnosis of neurosarcoidosis was eventually made through a skin biopsy.

The patient presented with progressive limb weakness and sensory disturbances and was initially treated for a presumptive diagnosis of GBS. Although her condition showed an initial temporary improvement, her symptoms subsequently relapsed and worsened. This atypical and relapsing clinical pattern prompted a comprehensive systemic workup to find an alternative diagnosis. Based on the histological findings on skin biopsy and the clinical presentation, a diagnosis of probable neurosarcoidosis was made.

This case highlights the importance of considering neurosarcoidosis in the differential diagnosis of GBS with an atypical course. A comprehensive systemic workup is crucial for such cases. It further emphasizes that a thorough systemic evaluation is essential for accurate diagnosis, as a simple and accessible procedure like a skin biopsy can provide essential histological evidence to support the diagnosis.

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