[Sarcoidosis with Cardiac Involvement and Monoclonal Gammopathy]

Area of Science:

• Cardiology
• Pulmonology
• Hematology

Background:

• Presents a rare clinical case of pulmonary sarcoidosis with intrathoracic lymphadenopathy and progressive myocardial injury.
• Highlights the unusual co-occurrence of monoclonal gammopathy in a patient with cardiac sarcoidosis.
• Notes the absence of morphological signs of paraproteinemic hemoblastosis and amyloidosis.

Purpose of the Study:

• To present an 8-year clinical follow-up of a patient with pulmonary sarcoidosis, myocardial injury, and monoclonal gammopathy.
• To discuss the diagnostic workup for cardiac sarcoidosis in a patient with coexisting monoclonal gammopathy.
• To explore the potential origins of monoclonal gammopathy in this specific clinical context.

Main Methods:

• Clinical case presentation with an 8-year follow-up.
• Comprehensive diagnostic evaluation including imaging and laboratory tests.
• Morphological examination to rule out specific hematological conditions.

Main Results:

• Demonstrated a gradually progressing myocardial injury in the context of pulmonary sarcoidosis.
• Identified monoclonal gammopathy as a rare, specific feature of the case.
• Confirmed the absence of paraproteinemic hemoblastosis and amyloidosis through morphological analysis.

Conclusions:

• Cardiac sarcoidosis diagnosis requires a comprehensive approach, especially with rare comorbidities like monoclonal gammopathy.
• The co-occurrence of monoclonal gammopathy and cardiac sarcoidosis is exceptionally rare and warrants further investigation.
• Understanding the origination of monoclonal gammopathy is crucial for managing patients with cardiac sarcoidosis.