Adalimumab for the treatment of cardiac sarcoidosis with multiple arrhythmias

A 45‐year‐old male with cardiac sarcoidosis verified by cardiac biopsy presented with multiple coexisting arrhythmias, including ventricular tachycardia of more than 1000 episodes per 24 h, paroxysmal atrial fibrillation, and third‐degree atrioventricular block. He did not respond to corticosteroids...

Full description

Saved in:
Bibliographic Details
Published in:ESC Heart Failure 2022-12, Vol.9 (6), p.4325-4329
Main Authors: Li, Sitong, Wang, Hui, Liu, Tong, Li, Qifan, Yang, Xiuxiu, Xiong, Ran, Lv, Qiang, Du, Xin, Dong, Jianzeng, Ma, Changsheng
Format: Article
Language:English
Subjects:
Adalimumab
Adalimumab - therapeutic use
Arrhythmias, Cardiac - complications
Atrioventricular Block - diagnosis
Atrioventricular Block - drug therapy
Atrioventricular Block - etiology
Biopsy
Cardiac arrhythmia
Cardiac magnetic resonance
Cardiac sarcoidosis
Cardiomyopathies - complications
Cardiomyopathies - diagnosis
Cardiomyopathies - drug therapy
Case reports
Contrast Media
Diarrhea
Electrocardiography
Fluorodeoxyglucose F18
Gadolinium
Granulomas
Heart failure
Humans
Inflammation
Inflammatory bowel disease
Male
Middle Aged
Monoclonal antibodies
Mycophenolic Acid
Myocarditis - complications
Patients
Physical education
Positron Emission Tomography Computed Tomography
Sarcoidosis
Sarcoidosis - complications
Sarcoidosis - diagnosis
Sarcoidosis - drug therapy
Steroids
TNF inhibitors
Tomography
Tumor necrosis factor-TNF
Tumour necrosis factor‐α inhibitor
Ventricular tachycardia
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 45‐year‐old male with cardiac sarcoidosis verified by cardiac biopsy presented with multiple coexisting arrhythmias, including ventricular tachycardia of more than 1000 episodes per 24 h, paroxysmal atrial fibrillation, and third‐degree atrioventricular block. He did not respond to corticosteroids dose of 20–60 mg once daily and mycophenolate mofetil dose of 1 g twice daily for 6 months. Cardiac magnetic resonance (CMR) demonstrated inflammation and late gadolinium enhancement on right ventricular wall and interventricular septum. Positron emission tomography‐computed tomography (PET‐CT) showed multifocal 18F‐fluorodeoxyglucose uptake in the heart. We replaced mycophenolate mofetil with adalimumab, a tumour necrosis factor‐α inhibitor. After 3 months, his arrhythmias improved significantly, manifesting as premature ventricular contractions of only 500 beats per 24 h and first‐degree atrioventricular block. CMR showed a significant reduction in inflammation and late gadolinium enhancement, and PET‐CT showed a complete resolution of fluorodeoxyglucose uptake.
ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.14133