Cardiac Sarcoidosis Concomitant with Large-vessel Aortitis Detected by 18F-fluorodeoxyglucose Positron Emission Tomography

Intern Med. 2018 Jun 1;57(11):1601-1604. doi: 10.2169/internalmedicine.9652-17. Epub 2018 Jan 11.

Abstract

We herein report a case of concurrent cardiac sarcoidosis and large-vessel aortitis detected by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and followed up during immunosuppressive therapy. After high-dose prednisolone administration (1 mg/kg), serial FDG-PET showed that almost all of the abnormal FDG uptake in the heart and extracardiac region, including the abdominal to bilateral iliac arteries, had been disappeared. During the tapering of prednisolone, additive methotrexate therapy was needed to treat the recurrence of cardiac sarcoidosis. FDG-PET is a useful tool for detecting cardiac sarcoidosis concomitant with large-vessel aortitis and monitoring the effectiveness of immunosuppressive therapy.

Keywords: FDG-PET; aortitis; cardiac sarcoidosis; methotrexate; prednisolone.

Publication types

  • Case Reports

MeSH terms

  • Aortitis / complications
  • Aortitis / diagnostic imaging*
  • Aortitis / therapy
  • Cardiomyopathies / complications
  • Cardiomyopathies / diagnostic imaging*
  • Cardiomyopathies / therapy
  • Female
  • Fluorodeoxyglucose F18
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppression Therapy
  • Immunosuppressive Agents / therapeutic use
  • Methotrexate / therapeutic use
  • Middle Aged
  • Positron-Emission Tomography
  • Prednisolone / therapeutic use
  • Radiopharmaceuticals
  • Sarcoidosis / complications
  • Sarcoidosis / diagnostic imaging*
  • Sarcoidosis / therapy

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Prednisolone
  • Methotrexate