title: Steroid pulse therapy was effective for cardiac sarcoidosis with ventricular tachycardia and systolic dysfunction.
abstract: A 32-year-old man presented with palpitation. He was diagnosed with pulmonary sarcoidosis by lung biopsy. The electrocardiogram showed first-degree atrioventricular block and complete right bundle branch block (CRBBB). We planned to examine laboratory data, echocardiography, Holter monitoring, and gallium-67 scintigraphy. Before he went through all these exams, he developed ventricular tachycardia. After defibrillation was performed, his electrocardiogram revealed complete atrioventricular block. We observed elevation of serum angiotensin-converting enzyme levels. In addition, both of gallium-67 scintigraphy and18F-fluorodeoxyglucose positron emission tomography showed abnormal uptake in the ventricular septum. We diagnosed the patient with cardiac sarcoidosis associated with these arrhythmias. We started treatment with methylprednisolone pulse therapy (1 g daily). After 3 days of steroid pulse therapy, we administered prednisolone 30 mg daily. On day 15, electrocardiogram changed from complete atrioventricular block to first-degree atrioventricular block and CRBBB. He was discharged with no progression with cardiac sarcoidosis for 2 years.
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Okabe
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Yakushiji
authors.affiliation: National Center for Global Health and Medicine Tokyo Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hiroe
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Oyama
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Igawa
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Ono
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kido
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Ebara
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Kennosuke
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Myong Hwa
authors.initials: MH
authors.lastname: Yamamoto
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Saito
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hoshimoto
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Amemiya
authors.initials: A
authors.lastname: Kisaki
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Naoei
authors.initials: N
authors.lastname: Isomura
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Araki
authors.affiliation: Division of Cardiology and Cardiac Catheterization Laboratories Showa University Northern Yokohama Hospital Yokohama Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ochiai
keywords: Arrhythmia; Cardiac sarcoidosis; Steroid pulse therapy