Prolonged Uhthoff phenomenon in sarcoidosis.

Abstract

To report a patient with sarcoidosis of the anterior visual pathways in whom one of the primary symptoms was visual loss lasting 24 hours after exposure to heat. Case report and review of the literature. The transient visual loss was exquisitely sensitive to intravenous corticosteroids and lasted longer than the typical Uhthoff phenomenon. Serum angiotensin-converting enzyme level was increased, chest x-ray showed hilar adenopathy, gallium scan disclosed bilateral intense tracer uptake in the hila, and transbronchial lung biopsy showed noncaseating granulomas with negative stains for fungi and mycobacteria, consistent with sarcoidosis. Uhthoff phenomenon, typically associated with demyelinating optic neuritis, may occur in an atypical form in patients with sarcoidosis of the optic nerve.