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Case Reports in Immunology
Volume 2014 (2014), Article ID 876525, 6 pages
http://dx.doi.org/10.1155/2014/876525
Case Report

Infectious and Noninfectious Granulomatosis in Patient with Multiple Sclerosis: Diagnostic Dilemmas and Followup

1University Eye Clinic, Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
2Primary Health Care Center, Jove Negusevica 5, 22140 Pecinci, Serbia

Received 11 November 2013; Accepted 5 January 2014; Published 17 February 2014

Academic Editors: A. M. Mansour and A. Vojdani

Copyright © 2014 Jelena Paovic et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patient was followed up over the course of 30 years. In 1978, after severe systemic infection followed by fever, pulmonary edema, and numerous neurological manifestations, patient was differentially diagnosed with apoplectic form of multiple sclerosis (MS), which was confirmed a year later via neurological and MRI findings. Approximately 20 years following the initial attack, sarcoidosis was diagnosed during the regular preoperative procedures required for cataract surgery. As consequence of lower immune system, infectious granulomatosis in form of pulmonary tuberculosis developed. Ophthalmological findings revealed bilateral retrobulbar neuritis (RBN) approximately six years after initial attack. This developed into total uveitis with retinal periphlebitis and anterior granulomatous uveitis—all of which are clinically similar in both MS and sarcoidosis.