Remission of Cardiac Sarcoidosis after the Administration of Methotrexate as First-line Drug Therapy

A 54-year-old woman developed new-onset heart failure and was diagnosed with cardiac sarcoidosis. An implantable cardioverter-defibrillator with biventricular pacing was implanted before immunosuppressive therapy to prevent sudden death. The patient refused oral steroids because she disliked their s...

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Published inInternal Medicine Vol. 63; no. 15; pp. 2149 - 2152
Main Authors Yamasaki, Hirochika, Kondo, Hidekazu, Ogawa, Naoko, Mitarai, Kazuki, Ishi, Yumi, Saito, Shotaro, Takahashi, Naohiko
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.08.2024
Japan Science and Technology Agency
Subjects
18F-fluorodeoxyglucose positron emission tomography
cardiac sarcoidosis
Cardiomyopathies - chemically induced
Cardiomyopathies - drug therapy
Cardiomyopathies - therapy
Cardiovascular diseases
Case Report
Congestive heart failure
corticosteroids
Defibrillators
Drug therapy
Female
Heart Failure - drug therapy
Humans
Immunosuppressive agents
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Methotrexate
Methotrexate - administration & dosage
Methotrexate - adverse effects
Methotrexate - therapeutic use
Middle Aged
Muscle contraction
Positron emission tomography
Remission
Remission Induction
Sarcoidosis
Sarcoidosis - drug therapy
Steroid hormones
Treatment Outcome
methotrexate
18F-fluorodeoxyglucose positron emission tomography
cardiac sarcoidosis
corticosteroids
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Summary:A 54-year-old woman developed new-onset heart failure and was diagnosed with cardiac sarcoidosis. An implantable cardioverter-defibrillator with biventricular pacing was implanted before immunosuppressive therapy to prevent sudden death. The patient refused oral steroids because she disliked their specific side effects and potential adverse events with long-term use; therefore, methotrexate was chosen as an alternative first-line drug. Nine months after starting oral therapy, 18F-fluorodeoxyglucose-positron emission tomography revealed remission of sarcoidosis, disappearance of heart failure symptoms, marked improvement in cardiac contractility, and a reduced frequency of ventricular arrhythmias.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
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Correspondence to Dr.　Hidekazu Kondo, hkondo@oita-u.ac.jp
ISSN:0918-2918
1349-7235
1349-7235
DOI:10.2169/internalmedicine.2759-23