When would you consider referring a patient with suspected cardiac sarcoidosis based on PET and MRI for endomyocardial biopsy given degree of patchy involvement, as opposed to initiating empiric immunosuppressive therapies?
Is there any utility in ACE levels and/or IL-2 levels in the diagnostic work-up of cardiac sarcoidosis?
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Would you consider starting empiric immunosuppressive therapy for a patient with suspected cardiac sarcoidosis based on PET and MRI findings, without a tissue diagnosis?
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2 Answers
Mednet Member
Cardiology · New York Medical College
Answered on
I would avoid initiating empiric immunosuppressive therapies without a firm diagnosis of sarcoidosis. I will mention however that the latest Japanese Circulation Society criteria for the diagnosis of sarcoidosis do include criterion for the non-invasive diagnosis of likely cardiac sarcoidosis based ...
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Mednet Member
Rheumatology · Baptist Health Jacksonville Rheumatology
Answered on · Updated on
Very fascinating question!
So it seems that my practice and experience seems to differ a lot from many others. I commonly start immunosuppression empirically in patients with cardiac (including isolated cardiac) sarcoidosis, and very rarely do I get biopsies.
Most commonly, when I do get biopsies, I...
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