The challenge of profound hypoglycorrhachia: two cases of sarcoidosis and review of the literature

Clin Rheumatol. 2011 Dec;30(12):1631-9. doi: 10.1007/s10067-011-1834-y. Epub 2011 Aug 26.


We report two cases of sarcoidosis which were initially misdiagnosed due to profound hypoglycorrhachia. Sarcoidosis is a systemic inflammatory disorder which can mimick other entities and has a vast array of presentations including altered mentation and signs of increased intracranial pressure. Though hypoglycorrhachia has been described previously, these two cases are unique in not only the level of hypoglycorrhachia but also the diagnostic challenge presented. We propose that sarcoidosis should be in the differential of all cases of CNS diseases with any level of hypoglycorrhachia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Biopsy
  • Diagnosis, Differential
  • Female
  • Glucocorticoids / therapeutic use
  • Glucose / cerebrospinal fluid*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pituitary Diseases / cerebrospinal fluid
  • Pituitary Diseases / diagnosis*
  • Pituitary Diseases / drug therapy
  • Prednisone / therapeutic use
  • Sarcoidosis / cerebrospinal fluid
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / drug therapy
  • Tuberculosis, Meningeal / cerebrospinal fluid
  • Tuberculosis, Meningeal / diagnosis*
  • Tuberculosis, Meningeal / drug therapy


  • Glucocorticoids
  • Glucose
  • Prednisone