Amyotrophic lateral sclerosis associated with sarcoidosis

We report a rare association of amyotrophic lateral sclerosis (ALS) with in cidental pulmonary and muscle sarcoidosis. A 63-year-old woman presented wi th slowly progressive weakness and atrophy of the extremities starting from the left leg. The biopsy of a small mass in the left gastrocnemius reveale d a typical sarcoid nodule. She was treated with corticosteroid for possibl e sarcoid neuromyopathy. In spite of the treatment, her clinical course was relentlessly progressive and she died of bulbar palsy. Autopsy revealed a loss of motor neurons in the anterior horn, vacuolar degeneration of the la teral funiculus, and noncaseating granulomas in paratracheal lymph nodes an d lungs. No granulomatous lesion or cellular infiltration was found in the spinal cord.