Cardiac sarcoidosis with a twist - active and fibrotic sarcoid with antiphospholipid positivity: A case report.

Publication/Presentation Date

12-26-2025

Abstract

BACKGROUND: Cardiac sarcoidosis (CS) is an infiltrative disease with manifestations such as non-sustained ventricular tachycardia (NSVT) and heart failure (HF). Antiphospholipid syndrome (APS) and antiphospholipid positivity (APP) are prothrombotic phenomena which elevate risk for thromboembolism. CS with active systemic sarcoid and APS/APP is a rare combination of diseases.

CASE SUMMARY: A 54 year old male with HF presented with several cardiopulmonary symptoms. Chest imaging showed bilateral patchy and reticulonodular infiltrates. Subsequent lung biopsy confirmed pulmonary sarcoidosis. Positron emission tomography revealed active systemic sarcoidosis (SS) and fibrotic CS. Positive antiphospholipid antibodies without thromboembolism confirmed APP. HF and APP were managed with medical therapy. Fibrotic CS and NSVT required permanent cardiac device and antiarrhythmic therapy. SS was managed with early taper of steroids and transition to biologics.

CONCLUSION: Fibrotic CS with active SS and APS/APP has not been previously described in literature. This case utilized a modified approach for the management of this combination of diseases. As immunosuppressants such as steroids have limited utility in fibrotic sarcoidosis and a potential for thromboembolic complications in the presence of APP, an accelerated transition to non-thrombotic immunosuppressants can be advantageous in the long term treatment of this combination of diseases.

Volume

17

Issue

12

First Page

112389

Last Page

112389

ISSN

1949-8462

Disciplines

Medicine and Health Sciences

PubMedID

41480004

Department(s)

Fellows and Residents

Document Type

Article

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