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Infliximab Treatment of Refractory Cardiac Sarcoidosis
Majid Asawaeer1, Benjamin Widener2, Varda Singhal1
1Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
JACC. Case Reports
|July 28, 2021
Summary
Cardiac sarcoidosis can be difficult to treat. This case study shows successful treatment with infliximab (tumor necrosis factor-α inhibitor) and highlights the role of imaging in guiding therapy.
Area of Science:
- Cardiology
- Immunology
- Nuclear Medicine
Background:
- Cardiac sarcoidosis is a rare granulomatous disease often refractory to conventional immunosuppressive therapy.
- Limited evidence exists on the efficacy and safety of tumor necrosis factor-α inhibitors in cardiac sarcoidosis.
- Concerns regarding potential cardiotoxicity and FDA black-box warnings for heart failure have restricted infliximab use.
Observation:
- A patient with refractory cardiac sarcoidosis was treated with infliximab.
- Fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) was utilized for disease assessment.
Findings:
- Successful treatment of refractory cardiac sarcoidosis was achieved with infliximab.
- 18F-FDG PET imaging played a crucial role in prognostication and therapeutic guidance.
- The patient tolerated infliximab without apparent cardiotoxicity.
Implications:
- Infliximab may be a viable therapeutic option for select patients with refractory cardiac sarcoidosis.
- 18F-FDG PET is a valuable tool for managing cardiac sarcoidosis.
- Further research is warranted to establish the long-term safety and efficacy of infliximab in this population.
Keywords:
18F-FDG, fluorine-18–fluorodeoxyglucoseCMR, cardiac magnetic resonanceCS, cardiac sarcoidosisPET, positron emission tomographyTNF, tumor necrosis factorcardiac sarcoidosisinfliximabmagnetic resonance imagingpositron emission tomographyMore Related Videos
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