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my mother was diagnosed with neurosarcoid...she received high dose steroids and cytoxan with good response. Her prednisone was tapered, but she has been unable to come off the last 1-2 mg despite being on Imuran as well. Is Imuran the correct med or are more people perscribing cellcept. also, two other woman (caucasion/jewish/60`s) in her neighborhood have been dxed....are there any new studies about environment?


It is good that your mother is responding to the current therapy. The treatment for neurosarcoidosis is not well-defined. There are a number of case reports (anecdotes) relating to the use of Cellcept, cytoxan or anti-TNF drugs (e.g., Infliximab or thalidomide) for cases of neurosarcoidosis that are resistant to more conventional therapies, including prednisone and methotrexate. If cytoxan is working for her, it is a reasonable approach. She should be monitored for changes in her white blood count and for inflammation of the bladder (cystitis). The latter can be avoided using a drug called Mesna. It is not uncommon to require more than one drug to control neurosarcoidosis. If she only requires 1-2 mg of prednisone a day to help control the disease, this would be a relatively harmless treatment.

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Response by:

Elliott D Crouser, MD Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University