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2016 ; 3
(4
): 288-292
Nephropedia Template TP
gab.com Text
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Steroid pulse therapy was effective for cardiac sarcoidosis with ventricular
tachycardia and systolic dysfunction
#MMPMID27867531
Okabe T
; Yakushiji T
; Hiroe M
; Oyama Y
; Igawa W
; Ono M
; Kido T
; Ebara S
; Yamashita K
; Yamamoto MH
; Saito S
; Hoshimoto K
; Kisaki A
; Isomura N
; Araki H
; Ochiai M
ESC Heart Fail
2016[Dec]; 3
(4
): 288-292
PMID27867531
show ga
A 32-year-old man presented with palpitation. He was diagnosed with pulmonary
sarcoidosis by lung biopsy. The electrocardiogram showed first-degree
atrioventricular block and complete right bundle branch block (CRBBB). We planned
to examine laboratory data, echocardiography, Holter monitoring, and gallium-67
scintigraphy. Before he went through all these exams, he developed ventricular
tachycardia. After defibrillation was performed, his electrocardiogram revealed
complete atrioventricular block. We observed elevation of serum
angiotensin-converting enzyme levels. In addition, both of gallium-67
scintigraphy and (18)F-fluorodeoxyglucose positron emission tomography showed
abnormal uptake in the ventricular septum. We diagnosed the patient with cardiac
sarcoidosis associated with these arrhythmias. We started treatment with
methylprednisolone pulse therapy (1?g daily). After 3?days of steroid pulse
therapy, we administered prednisolone 30?mg daily. On day 15, electrocardiogram
changed from complete atrioventricular block to first-degree atrioventricular
block and CRBBB. He was discharged with no progression with cardiac sarcoidosis
for 2?years.