Journal of Neurology

, Volume 257, Issue 11, pp 1855–1863 | Cite as

Soluble CSF interleukin 2 receptor as indicator of neurosarcoidosis

  • Hela-Felicitas PetereitEmail author
  • Dirk Reske
  • Hayrettin Tumani
  • Sven Jarius
  • F. Markus Leweke
  • Dirk Woitalla
  • Hans-Walter Pfister
  • Andrea Rubbert
Original Communication


Neurosarcoidosis (NS) represents an important differential diagnosis of multiple sclerosis (MS). However, thus far no reliable laboratory marker of neurosarcoidosis exists. The objective of this study was to evaluate whether cerebrospinal fluid (CSF) levels of soluble interleukin 2 receptor (sIL2-R) distinguish NS and other inflammatory disorders of the central nervous system. For this purpose, 139 paired CSF and serum samples from 11 patients with NS, 21 with MS, 10 with CNS vasculitis, 22 with bacterial meningitis, 17 with viral meningitis/encephalitis, seven with neurotuberculosis, and 18 healthy donors were assessed for sIL2-R using an enzyme-linked immunosorbent assay. We found that sIL2-R CSF levels above 150 pg/ml identified untreated NS patients with an overall accuracy of 93% against a group of non-infectious CNS-diseases. Furthermore, an increase in sIL2-R in the CSF was associated with and preceded the outbreak of new neurological symptoms. In conclusion, these findings suggest that sIL2-R measurement in the CSF may be a valuable tool in the diagnosis and follow-up of patients with suspected and proven neurosarcoidosis.


Neurosarcoidosis Cerebrospinal fluid (CSF) Soluble interleukin 2 (sIL2) receptor 



We thank Hendrik Lindeman for excellent technical assistance.

Conflict of interest statement

The authors declare that they have no conflict of interest.


  1. 1.
    Kitaichi M (1998) Prevalence of sarcoidosis around the world. Diffuse Lung Dis 15:16–18Google Scholar
  2. 2.
    Hagerstrand I, Linell F (1964) The prevalence of sarcoidosis in the autopsy material from a Swedish town. Acta Med Scand Suppl 425:171–174PubMedGoogle Scholar
  3. 3.
    Manz HJ (1983) Pathobiology of neurosarcoidosis and clinicopathologic correlation. Can J Neurol Sci 10:50–55PubMedGoogle Scholar
  4. 4.
    Mayock RL, Bertrand P, Morrison CE, Scott JH (1963) Manifestation of sarcoidosis: analysis of 145 Patients, with a review of nine series selected in the literature. Am J Med 35:67–89CrossRefPubMedGoogle Scholar
  5. 5.
    Stern BJ, Krumholz A, Johns C et al (1985) Sarcoidosis and its neurological manifestations. Arch Neurol 42:909–917PubMedGoogle Scholar
  6. 6.
    Vinas FC, Rengachary S (2001) Diagnosis and management of neurosarcoidosis. J Clin Neurosci 8:505–513CrossRefPubMedGoogle Scholar
  7. 7.
    Zajicek JP, Scolding NJ, Foster O et al (1999) Central nervous system sarcoidosis-diagnosis and management. Q J Med 92:103–117Google Scholar
  8. 8.
    Khoury J, Wellik KE, Demaerschalk BM, Wingerchuk DM (2009) Cerebrospinal fluid angiotensin-converting enzyme for diagnosis of central nervous system sarcoidosis. Neurologist 15:108–111CrossRefPubMedGoogle Scholar
  9. 9.
    Marangoni S, Argentiero V, Tavolato B (2006) Neurosarcoidosis: clinical description of 7 cases with a proposal for a new diagnostic strategy. J Neurol 253:488–495CrossRefPubMedGoogle Scholar
  10. 10.
    Joseph FG, Scolding NJ (2009) Neurosarcoidosis: a pilot study of 30 new cases. J Neurol Neurosurg Psychiatry 80:297–304CrossRefPubMedGoogle Scholar
  11. 11.
    Ziegenhagen MW, Benner UK, Zissel G et al (1997) Sarcoidosis: TNF-alpha release from alveolar macrophages and serum level of sIL-2R are prognostic markers. Am J Respir Crit Care Med 156:1586–1592PubMedGoogle Scholar
  12. 12.
    Grutters JC, Fellrath JM, Mulder L et al (2003) Serum soluble interleukin-2 receptor measurement in patients with sarcoidosis: a clinical evaluation. Chest 124:186–195CrossRefPubMedGoogle Scholar
  13. 13.
    Keicho N, Kitamura K, Takaku F, Yotsumoto H (1990) Serum concentration of soluble interleukin-2 receptor as a sensitive parameter of disease activity in sarcoidosis. Chest 98:1125–1129CrossRefPubMedGoogle Scholar
  14. 14.
    Muller-Quernheim J, Pfeifer S, Strausz J, Ferlinz R (1991) Correlation of clinical and immunologic parameters of the inflammatory activity of pulmonary sarcoidosis. Am Rev Respir Dis 144:1322–1329PubMedGoogle Scholar
  15. 15.
    Rubin LA, Kurman CC, Fritz ME et al (1985) Soluble interleukin 2 receptors are released from activated human lymphoid cells in vitro. J Immunol 135:3172–3177PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Hela-Felicitas Petereit
    • 1
    Email author
  • Dirk Reske
    • 2
  • Hayrettin Tumani
    • 3
  • Sven Jarius
    • 4
  • F. Markus Leweke
    • 5
  • Dirk Woitalla
    • 6
  • Hans-Walter Pfister
    • 7
  • Andrea Rubbert
    • 8
  1. 1.Department of NeurologyHoly Ghost HospitalCologneGermany
  2. 2.Department of NeurologyUniversity of CologneCologneGermany
  3. 3.Department of NeurologyUniversity of UlmUlmGermany
  4. 4.Division of Molecular Neuroimmunology, Department of NeurologyUniversity of HeidelbergHeidelbergGermany
  5. 5.Central Institute of Mental HealthMannheimGermany
  6. 6.Department of NeurologySt. Josef-Hospital, Ruhr-Universität BochumBochumGermany
  7. 7.Department of NeurologyKlinikum Großhadern, University of MunichMunichGermany
  8. 8.Department of Internal Medicine 1University of CologneCologneGermany

Personalised recommendations