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Unusual Clinical Presentation of Sarcoidosis with Thrombocytopenia, Bone Marrow Involvement, and Myocardial Infiltration: A Case Report
Abstract
This case study describes a 67-year-old female patient who presented with shortness of breath and quick exhaustion. In 2018, initial symptoms led to a diagnostic thoracic CT scan, which confirmed sarcoidosis using endobronchial ultrasound (EBUS). Despite the diagnosis, the patient did not receive treatment. A 2023 bone marrow biopsy revealed that the disease had progressed to include heart failure and thrombocytopenia. Transthoracic echocardiography (TTE) was used for cardiological examination, which revealed impaired left ventricular wall motion. Magnetic resonance imaging (MRI) revealed severe cardiac involvement by detecting full-thickness late gadolinium enhancement (LGE) in the left ventricle. This case report emphasizes the complexity and diversity of sarcoidosis symptoms, supporting a multidisciplinary approach for correct diagnosis and individual treatment approach.
Keywords
References
- Arkema EV, Grunewald J, Kullberg S, Eklund A, Askling J. Sarcoidosis incidence and prevalence: A nationwide register-based assessment in Sweden. European Respiratory Journal. 2016; 48(6):1690–1699. Available from: https://doi.org /10.1183/13993003.00477-2016
- Rossides M, Darlington P, Kullberg S, Arkema EV. Sarcoidosis: Epidemiology and clinical insights. Journal of Internal Medicine. 2023; 293(6):668–680. Available from: https:// doi.org/10.1111/joim.13629.
- Damsky W, Wang A, Kim DJ, Young BD, Singh K, Murphy MJ, Daccache J, Clark A, Ayasun R, Ryu C, McGeary MK, Odell ID, Fazzone-Chettiar R, Pucar D, Homer R, Gulati M, Miller EJ, Bosenberg M, Flavell RA, King B. Inhibition of type 1 immunity with tofacitinib is associated with marked improvement in longstanding sarcoidosis. Nature Communications. 2022; 13(1):1–17. Available from: https://doi.org/10.1038/s41467-022-30615-x
- American Thoracic Society. (1999). Statement on Sarcoidosis; ATS/ERS/WASGOG. Am J Resp Crit Care Med. 1999; 160(3):736–755. Available from: www.atsjournals.org
- Bernstein M, Konzlemann FW, Sidlick DM. Boeck's sarcoid: report of a case with visceral involvement. Archives of Internal Medicine. 1929; 44(5):721-734.
- Sugai M, Murata O, Oikawa H, Katagiri H, Matsumoto A, Nagashima H, Sugai T, Maemondo M. A case of bone marrow involvement in sarcoidosis with crescentic glomerular lesions. Respiratory Medicine Case Reports. 2020;28 (31):101202. Available from: https://doi.org/10.1016/j.rmcr. 2020.101202
- Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and management of sarcoidosis. American Family Physician. 2016; 93(10):840–848.
- Rahaghi FF, Baughman RP, Saketkoo LA, Sweiss NJ, Barney JB, Birring SS, Costabel U, Crouser ED, Drent M, Gerke AK, Grutters JC, Hamzeh NY, Huizar I, James WE, Kalra S, Kullberg S, Li H, Lower EE, Maier LA, Scholand MB. Delphi consensus recommendations for a treatment algorithm in pulmonary sarcoidosis. European Respiratory Review. 2020; 29(155). Available from: https://doi.org/10.1183/16000617.0146-2019
Details
Primary Language
English
Subjects
Health Services and Systems (Other)
Journal Section
Case Report
Publication Date
June 29, 2024
Submission Date
December 27, 2023
Acceptance Date
May 21, 2024
Published in Issue
Year 2024 Volume: 46 Number: 2