{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:24:31Z","timestamp":1776914671646,"version":"3.51.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:00:00Z","timestamp":1615334400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Severe cardiac sarcoidosis (CS) can share clinical and histopathologic features with giant cell myocarditis (GCM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 56-year-old female presented with 1\u2009week of exertional chest pressure and dyspnoea. Echocardiogram demonstrated extensive regional dysfunction with left ventricular ejection fraction (LVEF) 38%. Cardiac catheterization revealed no obstructive coronary artery disease and cardiac index 1.5\u2009L\/min\/m2. Cardiac magnetic resonance imaging (MRI) demonstrated diffuse late gadolinium enhancement. Positron emission tomography with fluorodeoxyglucose (FDG) (FDG-PET) computed tomography showed FDG uptake in the anteroseptal and anterior wall and no extracardiac activity. Endomyocardial biopsy (EMB) demonstrated fragments of endocardial fibrosis with mixed inflammatory infiltrate including histiocytic giant cells, which could be due to CS or GCM. She was initially treated for GCM with high dose steroids, tacrolimus, and mycophenolate mofetil. Repeat EMB was pursued and demonstrated multiple granulomas with sharp demarcation from adjacent uninvolved myocardium consistent with CS. A dual-chamber implantable cardioverter-defibrillator was placed, and immunosuppression was changed to prednisone alone with plan for infliximab.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case illustrates a rare presentation of fulminant isolated CS. Endomyocardial biopsy with sufficient tissue was critical to establish a diagnosis and initiate appropriate immunosuppression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab042","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T10:34:42Z","timestamp":1615458882000},"source":"Crossref","is-referenced-by-count":6,"title":["Fulminant cardiac sarcoidosis resembling giant cell myocarditis: a case report"],"prefix":"10.1093","volume":"5","author":[{"given":"Ginger Y","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA"},{"name":"Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-1706","authenticated-orcid":false,"given":"Qizhe","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E Wilson","family":"Grandin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA"},{"name":"Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa A","family":"Sabe","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Deaconess 1, Boston, MA 02215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"2021031108220910600_ytab042-B1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jacc.2016.03.605","article-title":"Cardiac sarcoidosis","volume":"68","author":"Birnie","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2021031108220910600_ytab042-B2","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1056\/NEJM199706263362603","article-title":"Idiopathic giant-cell myocarditis \u2014 natural history and treatment","volume":"336","author":"Cooper","year":"1997","journal-title":"N Engl J Med"},{"key":"2021031108220910600_ytab042-B3","doi-asserted-by":"crossref","first-page":"42","DOI":"10.17996\/anc.17-00042","article-title":"New guidelines for diagnosis of cardiac sarcoidosis in Japan","volume":"3","author":"Terasaki","year":"2017","journal-title":"Ann Nuclear Cardiol"},{"key":"2021031108220910600_ytab042-B4","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.hrthm.2014.03.043","article-title":"HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis","volume":"11","author":"Birnie","year":"2014","journal-title":"Heart Rhythm"},{"key":"2021031108220910600_ytab042-B5","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1378\/chest.11-0263","article-title":"Management of cardiac sarcoidosis in the United States","volume":"141","author":"Hamzeh","year":"2012","journal-title":"Chest"},{"key":"2021031108220910600_ytab042-B6","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.cjca.2013.02.004","article-title":"Corticosteroid therapy for cardiac sarcoidosis: a systematic review","volume":"29","author":"Sadek","year":"2013","journal-title":"Can J Cardiol"},{"key":"2021031108220910600_ytab042-B7","first-page":"1686","article-title":"Successful treatment of cardiac sarcoidosis with infliximab","volume":"35","author":"Barnabe","year":"2008","journal-title":"J Rheumatol"},{"key":"2021031108220910600_ytab042-B8","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1007\/s10067-007-0614-1","article-title":"Cardiac sarcoidosis responding to monotherapy with infliximab","volume":"26","author":"Uthman","year":"2007","journal-title":"Clin Rheumatol"},{"key":"2021031108220910600_ytab042-B9","doi-asserted-by":"crossref","first-page":"3542","DOI":"10.1002\/art.11357","article-title":"Successful tumor necrosis factor? 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