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The patient\u2019s neurological and haematological manifestations improved rapidly with intravenous methylprednisolone, intravenous immunoglobulin and PLEX. Her clinical course was complicated by sight-threatening steroid-induced glaucoma, adrenocortical insufficiency and diabetes mellitus. Her extra-ocular, extra-renal manifestations responded to oral glucocorticoid and intravenous cyclophosphamide therapy, while complete remission of ocular and renal disease was achieved with infliximab therapy at 12 and 24 months, respectively.<\/jats:p>","DOI":"10.1136\/bcr-2026-275128","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:25:17Z","timestamp":1788499517000},"page":"e275128","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Life-threatening multisystem sarcoidosis with neurological, renal, ocular and autoimmune haemolytic manifestations treated with intravenous immunoglobulin, plasma exchange, cyclophosphamide and infliximab"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8214-5021","authenticated-orcid":false,"given":"Kalpa","family":"Jayanatha","sequence":"first","affiliation":[{"name":"Medicine, The University of Auckland, Auckland, New Zealand"},{"name":"Renal Medicine, Middlemore Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sapsford","sequence":"additional","affiliation":[{"name":"Rheumatology, Middlemore Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Chaptynova","sequence":"additional","affiliation":[{"name":"Renal Medicine, Middlemore Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Medicine, The University of Auckland, Auckland, New Zealand"},{"name":"Stroke Medicine, Middlemore Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026090322250875000_19.9.e275128.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2021.09.025"},{"key":"2026090322250875000_19.9.e275128.2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14069"},{"key":"2026090322250875000_19.9.e275128.3","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2021.1890205"},{"key":"2026090322250875000_19.9.e275128.4","doi-asserted-by":"crossref","first-page":"3135","DOI":"10.1007\/s00415-020-09990-2","article-title":"Neurological involvement of coronavirus disease 2019: a systematic review","volume":"267","author":"Ghannam","year":"2020","journal-title":"J Neurol"},{"key":"2026090322250875000_19.9.e275128.5","article-title":"Clinical Spectrum and One-Year Outcomes of Central Nervous System Vasculitis Secondary to Systemic Autoimmune Disorders: A Retrospective Cohort Study","volume":"17","author":"Irfan","year":"2025","journal-title":"Cureus"},{"key":"2026090322250875000_19.9.e275128.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-016-0741-x","article-title":"Clinical features, treatment and outcome in neurosarcoidosis: systematic review and meta-analysis","volume":"16","author":"Fritz","year":"2016","journal-title":"BMC Neurol"},{"key":"2026090322250875000_19.9.e275128.7","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1001\/jama.2022.7765","article-title":"A Review of the Diagnosis and Treatment of Pulmonary Sarcoidosis","volume":"328","author":"Ben Salem","year":"2022","journal-title":"JAMA"},{"key":"2026090322250875000_19.9.e275128.8","doi-asserted-by":"crossref","first-page":"589","DOI":"10.25259\/ijn_222_23","article-title":"Clinical, Biochemical, and Histological Manifestations and Long-Term Outcomes of Renal Sarcoidosis - 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