Exploring the optimal reference to estimate the effect of anti-inflammatory therapy for the cardiac sarcoidosis -metabolic volume assessment of FDG PET-

1542Objectives: Cardiac sarcoidosis (CS) is rare but a potentially life-threatening disease that causes conduction disturbance, systolic dysfunction, and most notably sudden cardiac death. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) plays important roles not only in the diagnosis of CS but also in the evaluation of therapeutic effects of anti-inflammatory therapy. A volume-based analysis by FDG PET including cardiac metabolic volume (CMV) has emerged as a new assessment tool for measuring the volume within the boundary determined by reference tissue such as the liver and the blood pool uptake. However, oral steroid therapy could affect the uptake in the liver or in the blood pool uptake. Here, we attempted to evaluate and analyze the steroid effects on the liver and the blood pool uptake. Methods: A total of consecutive 38 patients who underwent FDG PET/CT for suspected or diagnosed CS were retrospectively enrolled. We assessed and compared the variation of liver and blood pool FDG uptake from pre- to during- steroid therapy. After the diagnosis of CS was established, oral steroid therapy was initiated. Daily maintenance dose of steroid was 27.6 ± 4.0 mg at the second scan and the duration between the scans was 61.5 ± 23.5 days. For the liver uptake, the threshold as SUVmean + 3 x standard deviation (SD) of the right lobe (RL) obtained from the semi-automated dedicated software and SUV assessed by manual process from th...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Poster Session Source Type: research

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Sarcoidosis is believed to be caused by both genetic and environmental risk factors, but the proportion of the susceptibility to sarcoidosis that is mediated by genetics remains unknown. We aimed to estimate the familial aggregation and heritability of sarcoidosis using a case–control–family study design and population-based Swedish registers. We identified 23 880 individuals with visits for sarcoidosis in the Swedish National Patient Register using International Classification of Diseases codes (1964-2013). Information on Löfgren's syndrome was available for a subset diagnosed at Karolinska University Hospit...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Articles: Interstitial lung diseases Source Type: research
Conclusions The results of the present study suggest that hITLN-1 may be involved in the pathogenesis of ICEP and HP, and that an increase in the hITLN-1 concentration in the BAL fluid may represent a new biomarker for these diseases. PMID: 30101907 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
CONCLUSION: EBUS-TBNA is associated with a risk of mediastinitis that may manifest as an isolated fever arising within hours of the procedure. The pathogens responsible are usually contaminants from the oropharynx such as Streptococcus sp, probably inoculated directly into the mediastinum during transbronchial needle aspiration. Rapid diagnosis and treatment are necessary in order to reduce morbidity and mortality associated with mediastinitis. PMID: 30098879 [PubMed - as supplied by publisher]
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
Authors: Kiko T, Yoshihisa A, Kanno Y, Yokokawa T, Abe S, Miyata-Tatsumi M, Misaka T, Oikawa M, Kobayashi A, Ishida T, Takeishi Y Abstract Sarcoidosis is a systemic granulomatous disease including heart (cardiac sarcoidosis, CS). It has recently been reported that isolated CS, which presenting primarily cardiac symptoms without clinical evidence of sarcoid involvement in other organs. Diagnostic and prognostic biomarkers of CS, especially in isolated CS, have not yet been established.We studied plasma levels of angiotensin-converting enzyme (ACE), soluble interleukin-2 receptor (sIL-2R), B-type natriuretic peptide ...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Authors: Ho JS, Chilvers ER, Thillai M Abstract INTRODUCTION: Sarcoidosis is a multisystem granulomatous disease predominantly affecting the lungs, with increased risk of cardiovascular disease, pulmonary hypertension and cardiac sarcoidosis (CS), the latter due to direct granuloma infiltration. Sarcoidosis is often managed by chest physicians who need to understand the diagnostic pathways and initial management plans for patients with cardiac involvement. Areas covered: The most serious consequence of CS is sudden cardiac death due to ventricular tachyarrhythmias or complete atrioventricular block. Additional comp...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
Endocrine Practice, Ahead of Print.
Source: Endocrine Practice - Category: Endocrinology Authors: Source Type: research
ConclusionsCerebrovascular events may be the first manifestation of neurosarcoidosis, and have a prognosis impact in such patients, leading to death and permanent neurological impairment.
Source: Journal of Neurology - Category: Neurology Source Type: research
Radiology, Ahead of Print.
Source: Radiology - Category: Radiology Authors: Source Type: research
AbstractA 40-year-old male was hospitalized with renal impairment and severe hypercalcemia. His concentration of serum IgG4 was high, but serum whole PTH, 1 –25(OH)2 vitamin D3 and PTHrP were not elevated. Computed tomography showed swelling of the bilateral lacrimal glands and systemic lymphadenopathy. The histological findings of lacrimal gland biopsy fulfilled the diagnostic criteria of IgG4-related ophthalmic disease (IgG4ROD). Bone scintigraphy showed increased ectopic uptake in the stomach, heart, lungs, and kidneys. He died on day 16 of admission, although the therapies for hypercalcemia were continued. Autops...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
Myocarditis due to granulomatous inflammation is being increasingly recognised compared to past when the diagnosis was usually made during autopsy. It comprises cardiac sarcoidosis (CS), cardiac tuberculosis (CTB) and other rare granulomatous disorders. It presents as ventricular tachycardias, atrio-ventricular conduction blocks with or without cardiomyopathy and heart failure. Paucity of constitutional symptoms and lack of awareness results in delayed diagnosis.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
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