Onset of sarcoidosis with left ventricular failure and multisystem involvement

A patient presented with acute left ventricular failure, then developed cranial nerve palsies, myopathy, fever and hyperuricemia. Sarcoidosis was not diagnosed until the pulmonary congestion cleared, revealing hilar adenopathy and residual mottling. Thereafter, uveitis was noted and scalene and muscle biopsies confirmed the diagnosis.