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This is a case report of a 64-year-old man with pulmonary sarcoidosis also affecting the joints. He was admitted to an emergency department following 21 days of fatigue, visual disturbances and headache. Initial blood tests revealed hypothalamic-pituitary dysfunction including acute adrenal insufficiency, and an MRI scan of the cerebrum showed a neurosarcoidosis tumour involving the hypothalamus-pituitary gland. Neurosarcoidosis is a condition with widespread clinical variation and early, and correct diagnosis is important.

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