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Review
Cardiac sarcoidosis
  1. Dae-Won Sohn1,2,
  2. Jun-Bean Park1
  1. 1 Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea
  2. 2 Seoul One-Heart CV Clinic, Seoul, South Korea
  1. Correspondence to Emeritus Prof. Dae-Won Sohn, Seoul National University College of Medicine Department of Internal Medicine, Seoul 03080, Korea (the Republic of); dwsohn{at}snu.ac.kr

Abstract

The diagnostic yield of endomyocardial biopsy in cardiac sarcoidosis (CS) is quite low because of the patchy involvement, and for the diagnosis of CS, existing guidelines required histological confirmation. Therefore, especially for isolated CS, diagnosis consistent with the guidelines cannot be made in a large number of patients. With recent developments in imaging modalities such as cardiac magnetic resonance and 18-fluorodeoxyglucose positron emission tomography, diagnosing CS has become easier and diagnostic criteria for CS not compulsorily requiring histological confirmation have been suggested. Despite significant advances in diagnostic tools, large-scale studies that can guide treatment plans are still lacking, and treatment has relied on the experience accumulated over the past years and the consensus of experts. However, opinions vary, depending on the situation, which is quite puzzling for the physician treating CS. Moreover, with the advent of new immunosuppressant agents, these new drugs have been applied under the assumption that the effect of immunosuppression is not much different from that of other well-known autoimmune diseases that require immunosuppression. However, we should wait to see the beneficial effects of these new immunosuppressants before we attempt to apply these agents in our clinical practice. This review summarises the widely used diagnostic criteria, current diagnostic modalities and recommended treatments for sarcoidosis. We have added our opinions on selecting or modifying diagnostic and treatment plans from the diverse current recommendations.

  • Cardiomyopathies

https://doi.org/10.1136/heartjnl-2022-321379

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    Footnotes

    • Correction notice This article has been corrected since it was first published to correct author name Jun-Bean Park, and to remove duplicated text in Table 1.

    • Contributors DW-S wrote the manuscript and prepared the illustrations. JB-P reviewed the manuscript and supplemented the missed points to be dealt with in the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.