Heerfordt-Waldenström Syndrome With Cardiac Sarcoidosis

Heerfordt-Waldenström syndrome is a rare presentation of sarcoidosis with only a handful of cases reported worldwide. It consists of a tetrad of uveitis, parotitis, and VII nerve palsy and chronic fever. Symptomatic cardiac involvement in sarcoidosis is an uncommon but potentially lethal manifestation. A timely diagnosis and treatment can result in the prevention of morbidity and mortality. We report a case of a young woman with multisystem sarcoidosis who presented with constitutional features, uveitis, multiple cranial nerve palsies, leptomeningitis, and ankle oligoarthritis. Supportive investigations, including chest imaging, granulomatous lymphadenitis on histopathology, and a negative interferon gamma release assay, helped to confirm the diagnosis. During the course of her hospitalization, she developed symptomatic cardiac conduction block. Her acute symptoms reversed rapidly, and she showed remarkable improvement with aggressive immunosuppression.