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Rare disease
A rare manifestation of sarcoidosis with sensomotoric neuropathy of the ulnar nerve as the only symptom
  1. Georg Mattiassich1,
  2. Heinrich Schubert2,
  3. Georg Hutarew3,
  4. Gottfried Wechselberger2
  1. 1Trauma Center Linz—Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria
  2. 2Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzigen Brueder Salzburg—Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
  3. 3Department of Pathology, Paracelsus Medical University (PMU) Salzburg, Salzburg, Austria
  1. Correspondence to Dr Georg Mattiassich, georg.mattiassich{at}gmx.at

Summary

A 79-year-old woman was admitted complaining of progressive weakness and numbness of the right hand. The patient was otherwise healthy. The patient's history was unremarkable. Clinical and electrophysiological examination revealed a compression of the ulnar nerve in the ulnar sulcus and in Guyon's canal. Ultrasound evaluation showed a suspicious tumour proximal to the elbow close to the ulnar nerve. The ulnar sulcus was then released and an epineural and perineural lesion 3–4 cm proximal to the sulcus was excised under microscope. The histopathology confirmed the lesion as non-caseating sarcoid granulomas. The patient showed no other signs of systemic sarcoidosis, as neuropathy was the only symptom and the condition improved postoperatively. Sensory deficits and paraesthesia resolved fully. The extension of the minor finger remained slightly inferior compared with the not affected side. Sarcoid neuropathy is a rare neurological complication of sarcoidosis and has to be included in differential diagnosis of nerve conduction impairments.

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