Cardiac Sarcoidosis Responding to Monotherapy with Infliximab

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2007 Mar 31

PMID 17394036

Citations 23

Authors

Imad Uthman

Zahi Touma

Maurice Khoury

Affiliations

Soon will be listed here.

Abstract

Cardiac involvement is a rare and potentially life-threatening complication of sarcoidosis. We report the case of a young previously healthy woman who presented with complete atrioventricular heart block. Further evaluation revealed non-caseating granulomas in the hilar and mediastinal regions. A pacemaker was inserted, and she was treated with four doses of infliximab after she refused treatment with steroids. Rapid resolution of the pulmonary lymph nodes was documented and repeated interrogations of the pacemaker 1 year after her last infliximab infusion documented that she was in sinus rhythm. Infliximab may be considered as an alternative first-line therapy in sarcoidosis with serious organ involvement.

Citing Articles

Controversies in the Treatment of Cardiac Sarcoidosis.

Obi O, Lower E, Baughman R Sarcoidosis Vasc Diffuse Lung Dis. 2022; 39(2):e2022015.

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Informed consent and biological agents in rheumatology and internal medicine.

Mandarelli G, Iannone F, Ferracuti S, Grattagliano I, Benevento M, Solarino B Eur J Clin Invest. 2022; 52(9):e13805.

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Case Report: TNFα Antagonists Are an Effective Therapy in Cardiac Sarcoidosis.

Stievenart J, Le Guenno G, Ruivard M, Rieu V, Andre M, Grobost V Front Cardiovasc Med. 2021; 8:676407.

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Ten Questions Cardiologists Should Be Able to Answer About Cardiac Sarcoidosis: Case-Based Approach and Contemporary Review.

Lemay S, Massot M, Philippon F, Belzile D, Turgeon P, Beaudoin J CJC Open. 2021; 3(4):532-548.

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Fulminant cardiac sarcoidosis resembling giant cell myocarditis: a case report.

Jiang G, Cai Q, Grandin E, Sabe M Eur Heart J Case Rep. 2021; 5(3):ytab042.

PMID: 33733047 PMC: 7947824. DOI: 10.1093/ehjcr/ytab042.

References

Roach D, Bean A, Demangel C, France M, Briscoe H, Britton W . TNF regulates chemokine induction essential for cell recruitment, granuloma formation, and clearance of mycobacterial infection. J Immunol. 2002; 168(9):4620-7. DOI: 10.4049/jimmunol.168.9.4620. View

Baughman R, Lower E . Infliximab for refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2001; 18(1):70-4. View

Silverman K, Hutchins G, Bulkley B . Cardiac sarcoid: a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation. 1978; 58(6):1204-11. DOI: 10.1161/01.cir.58.6.1204. View

Baughman R, Drent M, Kavuru M, Judson M, Costabel U, du Bois R . Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006; 174(7):795-802. DOI: 10.1164/rccm.200603-402OC. View

Carter J, Valeriano J, Vasey F, Bognar B . Refractory neurosarcoidosis: a dramatic response to infliximab. Am J Med. 2004; 117(4):277-9. DOI: 10.1016/j.amjmed.2004.03.013. View

Ulbricht K, Stoll M, Bierwirth J, Witte T, Schmidt R . Successful tumor necrosis factor alpha blockade treatment in therapy-resistant sarcoidosis. Arthritis Rheum. 2003; 48(12):3542-3. DOI: 10.1002/art.11357. View

Iwai K, Sekiguti M, Hosoda Y, DeRemee R, Tazelaar H, Sharma O . Racial difference in cardiac sarcoidosis incidence observed at autopsy. Sarcoidosis. 1994; 11(1):26-31. View

Veinot J, Johnston B . Cardiac sarcoidosis--an occult cause of sudden death: a case report and literature review. J Forensic Sci. 1998; 43(3):715-7. View

Sharma O . Diagnosis of cardiac sarcoidosis: an imperfect science, a hesitant art. Chest. 2003; 123(1):18-9. DOI: 10.1378/chest.123.1.18. View

10.

Yee A, Pochapin M . Treatment of complicated sarcoidosis with infliximab anti-tumor necrosis factor-alpha therapy. Ann Intern Med. 2001; 135(1):27-31. DOI: 10.7326/0003-4819-135-1-200107030-00010. View

11.

Chung E, Packer M, Lo K, Fasanmade A, Willerson J . Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF Therapy Against Congestive Heart.... Circulation. 2003; 107(25):3133-40. DOI: 10.1161/01.CIR.0000077913.60364.D2. View

12.

Shabetai . Sarcoidosis and the Heart. Curr Treat Options Cardiovasc Med. 2000; 2(5):385-398. DOI: 10.1007/s11936-000-0034-x. View

13.

Prior C, Knight R, Herold M, Ott G, Spiteri M . Pulmonary sarcoidosis: patterns of cytokine release in vitro. Eur Respir J. 1996; 9(1):47-53. DOI: 10.1183/09031936.96.09010047. View

14.

Chapelon-Abric C, de Zuttere D, Duhaut P, Veyssier P, Wechsler B, Le Thi Huong D . Cardiac sarcoidosis: a retrospective study of 41 cases. Medicine (Baltimore). 2004; 83(6):315-334. DOI: 10.1097/01.md.0000145367.17934.75. View

15.

Doty J, Mazur J, Judson M . Treatment of sarcoidosis with infliximab. Chest. 2005; 127(3):1064-71. DOI: 10.1378/chest.127.3.1064. View