A Patient with Cardiac Sarcoidosis in Whom an Abnormal Myocardial Uptake of Fluorine-18 Fluorodeoxyglucose and Sustained Ventricular Tachycardia Recurred 3.5 Years after Discontinuing Oral Corticosteroid Therapy

Intern Med. 2020 Sep 15;59(18):2275-2280. doi: 10.2169/internalmedicine.4524-20. Epub 2020 Jun 15.

Abstract

We herein report a woman diagnosed with cardiac sarcoidosis (CS) based on the presence of epithelioid granulomas in non-cardiac organs and clinical findings including sustained ventricular tachycardia (VT) and cardiac dysfunction. She stopped oral corticosteroid after 4 years of treatment, and an abnormal myocardial uptake of fluorine-18 fluorodeoxyglucose and sustained VT recurred 3.5 years later. There is no consensus concerning whether or not corticosteroid therapy should be discontinued in the treatment of CS. As a relapse of sarcoidosis-related inflammation may be associated with life-threatening arrhythmia, some patients should continue corticosteroid therapy, even at low doses.

Keywords: diagnostic imaging; disease activity; life-threatening arrhythmias; ventricular dysfunction.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Cardiomyopathies / complications
  • Cardiomyopathies / pathology*
  • Female
  • Fluorodeoxyglucose F18 / pharmacokinetics
  • Humans
  • Middle Aged
  • Sarcoidosis / complications
  • Sarcoidosis / pathology*
  • Tachycardia, Ventricular / complications
  • Tachycardia, Ventricular / pathology*
  • Tachycardia, Ventricular / therapy

Substances

  • Adrenal Cortex Hormones
  • Fluorodeoxyglucose F18