Clinical Research in Cardiology

, Volume 108, Issue 10, pp 1171–1173 | Cite as

Recurrent cardiac sarcoidosis after heart transplantation

  • Giacomo VeroneseEmail author
  • Manlio Cipriani
  • Duccio Petrella
  • Stefano Geniere Nigra
  • Patrizia Pedrotti
  • Andrea Garascia
  • Gabriella Masciocco
  • Manuela A. Bramerio
  • Karin Klingel
  • Maria Frigerio
  • Enrico AmmiratiEmail author
Letter to the Editors


A 42-year-old man with a history of arterial hypertension and aortic coarctation repair at the age of 25 received a dual-chamber pacemaker (PM) for a complete trifascicular block associated with a non-dilated mildly dysfunctional left ventricle (LV ejection fraction [EF], 45%). Angiography ruled out coronary artery disease. Progressive LV dysfunction leading to advanced heart failure (HF) (LVEF 27%) occurred in the next 3 years despite optimal medical therapy and upgrade to cardiac resynchronization therapy-defibrillator being performed when he was 44. The patient was diagnosed with a dilated cardiomyopathy resulting from long-standing arterial hypertension due to a lately repaired aortic coarctation; thus, no endomyocardial biopsy (EMB) or cardiac magnetic resonance imaging (CMRI) was performed in the early course of his disease. At the age of 45, the patient was referred to our transplant center for cardiogenic shock despite inotropic support, for advanced diagnostic workup and...


Author contributions

All authors had access to the data and a role in writing this manuscript.



Compliance with ethical standards

Conflict of interest

All authors agreed to submit this case report and declared no conflict of interests.

Supplementary material

392_2019_1485_MOESM1_ESM.tiff (5.3 mb)
Seriate chest X-rays showing progression toward a dilated cardiomyopathy with a progressive enlargement of the cardiac silhouette and the persistence of bilateral hilar lymphadenopathy. (A) Performed at the time of admission for complete trifascicular block and subsequent dual-chamber pacemaker implantation. (B) Performed after 15 months from dual-chamber pacemaker implantation. (C) Performed at the time of cardiac resynchronization therapy-defibrillator upgrade. (TIFF 5464 kb)

Apical four-chamber echocardiogram view showing recovery of cardiac function occurring after treatment with intravenous high dose steroids (methylprednisolone 500 mg for 3 days) at the time of cardiac sarcoidosis recurrence (1-week follow-up). (MOV 1078 kb)

On the left, positron emission tomography performed after steroid withdrawal during graft dysfunction highlighting intense hilar and mediastinal lymphnodes fludeoxyglucose uptake, suggestive of increased sarcoidosis activity. On the right, repeated positron emission tomography on corticosteroid therapy showing resolution of fludeoxyglucose uptake in hilar and mediastinal lymphnodes (10-month follow-up). (MOV 1083 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.“De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano NiguardaMilanItaly
  2. 2.Department of Health ScienceUniversity of Milano-BicoccaMilanItaly
  3. 3.Department of Emergency Medicine“M. Bufalini” HospitalCesenaItaly
  4. 4.Cardiopathology, Institute for PathologyUniversity Hospital TübingenTübingenGermany

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