Spinal Cord Sarcoidosis: An Unusual Cause of Neurogenic Bladder Dysfunction

We report a case of spinal cord sarcoidosis in which urodynamic studies showed neurogenic bladder dysfunction. A 56-year-old Caucasian woman developed progressive weakness of both lower extremities causing walking disturbance . Two months later, she became unable to walk, and she gradually developed urinary urgency, nocturnal urinary frequency, and urge urinary incontinence. Spinal MRI disclosed dorsal lesion, with atrophy of the cervical cord; the brain MRI was normal . Cerebrospinal fluid (CSF) analysis showed elevated proteins. Serum angiotensin-converting enzyme (ACE) level was moderately high. The tuberculin skin test was negative. The thoraco-abdomino-pelvien scanner showed a suspicious lesion in the liver. The draining biopsy of the liver revealed non-caseating epithelioid granuloma. This finding confirmed the diagnosis of spinal cord sarcoidosis. The urodynamic study showed detrusor hyperreflexia. Prednisolone treatment improved the urinary and neurological symptoms. The spinal lesion seems to be responsible for the mictional disturbance in our patient with spinal cord sarcoidosis. doi:10.4021/jnr21e