Infliximab Treatment of Refractory Cardiac Sarcoidosis

Majid Asawaeer, MD; Benjamin Widener, MD; Varda Singhal, MBBS; Matthew J. DeVries, MD; Debra J. Romberger, MD; Alan R. Erickson, MD; Yiannis S. Chatzizisis, MD, PhD

JACC: Case Reports (Aug 2020)

Infliximab Treatment of Refractory Cardiac Sarcoidosis

Majid Asawaeer, MD,
Benjamin Widener, MD,
Varda Singhal, MBBS,
Matthew J. DeVries, MD,
Debra J. Romberger, MD,
Alan R. Erickson, MD,
Yiannis S. Chatzizisis, MD, PhD

Affiliations

Majid Asawaeer, MD: Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Benjamin Widener, MD: Division of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska
Varda Singhal, MBBS: Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Matthew J. DeVries, MD: Division of Radiology, University of Nebraska Medical Center, Omaha, Nebraska
Debra J. Romberger, MD: Division of Pulmonary and Critical Care Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Alan R. Erickson, MD: Division of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska
Yiannis S. Chatzizisis, MD, PhD: Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska; Address for correspondence: Dr. Yiannis S. Chatzizisis, Cardiovascular Division, University of Nebraska Medical Center, Omaha, Nebraska 68198.

Journal volume & issue: Vol. 2, no. 10
pp. 1553 – 1557

Abstract

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Treatment of cardiac sarcoidosis is challenging, as the disease can be refractory to traditional treatment with steroids. Infliximab, a tumor necrosis factor-α inhibitor, has been reportedly used in cardiac sarcoidosis, but published evidence is limited. The potential cardiotoxicity of infliximab and the Food and Drug Administration black-box warning for patients with heart failure have hindered the use of this agent in cardiac sarcoidosis. Here, we report a case of refractory cardiac sarcoidosis successfully treated with infliximab and discuss the important role of fluorine-18–fluorodeoxyglucose positron emission tomography in prognostication and guidance of therapy. (Level of Difficulty: Intermediate.)

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

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Abstract

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