Recurrent Syncope Due to Concurrent Cardiac Sarcoidosis and Large-Vessel Vasculitis
Challenging differential diagnosis, Rare co-existance of disease or pathology
Hannah K. Gendelman, Marwa Sabha, Anton A. Gryaznov, Bernadette C. Siaton
Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
Am J Case Rep 2021; 22:e927331
DOI: 10.12659/AJCR.927331
Available online: 2020-12-14
Published: 2021-01-29

BACKGROUND:
Cardiac sarcoidosis and large-vessel vasculitis are both rare diseases with a variety of presenting symptoms. Both can result in high morbidity and mortality if not diagnosed early. While they are each relatively uncommon on their own, there have been a few reports suggesting they may be more related than previously thought. This case report suggests that the 2 diseases can become symptomatic concurrently, complicating diagnosis.
CASE REPORT:
A 68-year-old male patient was diagnosed concurrently with cardiac sarcoidosis and vasculitis after several episodes of syncope thought to be due to arrhythmia. The patient was treated with high-dose corticosteroids, and repeat imaging showed decreased inflammatory changes in the cardiac tissue and large blood vessels.
CONCLUSIONS:
Prior case reports have described vasculitis and sarcoidosis in the same patient; however, these patients usually had a long history of known sarcoidosis involving several organ systems. This case suggests that physicians should be alert to more limited forms of the disease in a patient with cardiac myopathy of unknown origin with new arrythmia. More research is also needed to determine how granulomatous disease and vasculitis are related to each other.
Keywords: sarcoidosis, Syncope, Vasculitis