Nakamura Satoshi, Hashimoto Yoshio, Nishi Kaoru, Takeda Keiko, Mizumoto Toshihiro, Demitsu Toshio, Iizuka Hajime
Department of Dermatology, Jichi Medical University, Saitama Medical Center, Tennumacho 1-847, Oomiya 330-8503, Saitama, Japan.
J Med Case Rep. 2014 Jan 15;8:17. doi: 10.1186/1752-1947-8-17.
Myocardial sarcoidosis is known as a significant complication of sarcoidosis, but Holter electrocardiographic monitoring or echocardiograms might not be sensitive enough to detect cardiac involvement. While gallium scintigraphy has been recommended, 18F-fluorodeoxyglucose positron emission tomography-computed tomography might be more sensitive to detect sarcoidosis.
This report comprises the cases of 12 Japanese patients. Two were male, and ten were female. Their age range was between 32 and 93 years. The average age of the patients was 63. We found internal involvement of sarcoidosis in eight (89%) of nine patients by positron emission tomography-computed tomography and in two (67%) of three patients by gallium scintigraphy. Myocardial sarcoidosis was detected in four (33%) of twelve patients, and specifically in three (75%) of four facial multiple plaque type sarcoidosis patients.
The myocardial lesions detected by positron emission tomography-computed tomography could not be detected with conventional electrocardiogram or echogram. Positron emission tomography-computed tomography can detect sarcoid lesions of the whole body and is useful for the follow up of patients. We recommend positron emission tomography-computed tomography for those patients having cutaneous sarcoidosis, especially facial multiple plaque type sarcoidosis.
心肌结节病是结节病的一种重要并发症,但动态心电图监测或超声心动图可能对检测心脏受累不够敏感。虽然推荐使用镓闪烁显像,但18F-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描在检测结节病方面可能更敏感。
本报告包含12例日本患者的病例。其中2例为男性,10例为女性。他们的年龄在32岁至93岁之间。患者的平均年龄为63岁。通过正电子发射断层扫描-计算机断层扫描,我们在9例患者中的8例(89%)发现了结节病的内部受累,通过镓闪烁显像在3例患者中的2例(67%)发现了结节病的内部受累。在12例患者中的4例(33%)检测到心肌结节病,特别是在4例面部多发斑块型结节病患者中的3例(75%)检测到心肌结节病。
通过正电子发射断层扫描-计算机断层扫描检测到的心肌病变无法通过传统心电图或超声心动图检测到。正电子发射断层扫描-计算机断层扫描可以检测全身的结节病病变,对患者的随访很有用。对于患有皮肤结节病,尤其是面部多发斑块型结节病的患者,我们推荐使用正电子发射断层扫描-计算机断层扫描。