Low CSF Glucose Level in Sarcoidosis Involving the Central Nervous System

Sarcoidosis, a systemic granulomatous disease of undetermined etiology and pathogenesis,¹may involve multiple organs and produce a wide spectrum of clinical manifestations.²,³The nervous system is not commonly affected,⁴⁻⁶but when it is, neurologic manifestations are protean. Recently Siltzbach outlined the clinical features observed in 311 cases of sarcoidosis diagnosed at the Sarcoidosis Clinic at the Mount Sinai Hospital in New York from 1946 to 1961.⁷Four of the patients experienced a mode of onset referable to the nervous system, and 13 (4%) had evidence of nervous system involvement sometime during the course of their disease. Although there are a number of publications which describe the neurologic manifestations of sarcoidosis,⁶,⁸we were unable to find a review of the changes which occur in the cerebrospinal fluid (CSF) in this entity. Sarcoidosis is rarely considered in the differential diagnosis of low CSF glucose, probably because most