What is your approach to monitoring patients with cardiac sarcoid while tapering immunosuppression?
Monitoring of patients with cardiac sarcoidosis (CS) is critical to optimizing therapy and improving outcomes.
Once a decision has been made to institute immunosuppressive therapy, it is important that the efficacy of therapy is demonstrated and that the duration of therapy is guided by the response.
Monitoring of efficacy can be achieved by symptom improvement, EKG echocardiogram and specific imaging utilized to establish the dx of CS.
Monitoring these parameters as we taper the IS therapy is important. The PET scan as the most informative for inflammatory changes, should be repeated as the treatment is being tapered. When to obtain the follow-up PET, has not been established (halfway point of tapering, when fully tapered or at determined points in the course?). I do utilize the PET to guide the tapering of IS.