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CASE SUMMARY: A 54-year-old man with heart failure had multiple cardiopulmonary symptoms; imaging and lung biopsy confirmed pulmonary sarcoidosis. Positron emission tomography showed active systemic sarcoidosis and fibrotic CS. Antiphospholipid antibodies were positive without thromboembolism, defining APP; management combined medical therapy, permanent device and antiarrhythmic treatment, and early steroid taper with transition to biologics. CONCLUSION: The combination of fibrotic CS with active systemic sarcoidosis and APS/APP has not been previously described, supporting an accelerated shift to non-thrombotic immunosuppressants.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/cardiac-sarcoidosis-with-a-twist-active-and-fibrotic-sarcoid-with-antiphospholipid-positivity-a-case-report/406217/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/cardiac-sarcoidosis-with-a-twist-active-and-fibrotic-sarcoid-with-antiphospholipid-positivity-a-case-report/406217.png","ImageObject",300,407,{"name":42,"@type":43},"Sarah ","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-05","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What rare disease combination is highlighted in this case report?","Question",{"text":63,"@type":64},"Fibrotic cardiac sarcoidosis coexisting with active systemic sarcoidosis and antiphospholipid syndrome/antiphospholipid positivity is presented as a rare combination not previously described in the literature.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was active systemic sarcoidosis and fibrotic cardiac sarcoidosis identified?",{"text":68,"@type":64},"Chest imaging and lung biopsy confirmed pulmonary sarcoidosis, while positron emission tomography demonstrated active systemic sarcoidosis and fibrotic cardiac sarcoidosis.",{"name":70,"@type":61,"acceptedAnswer":71},"How were antiphospholipid positivity and heart failure managed?",{"text":72,"@type":64},"Positive antiphospholipid antibodies without thromboembolism confirmed APP, and heart failure with APP was managed with medical therapy; fibrotic CS and nonsustained ventricular tachycardia required a permanent cardiac device and antiarrhythmic therapy.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},406217,1791101370,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":124,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},962085320529,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","| W | J | C | World Journal of\u003Cbr>Cardiology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Cardiol 2025 December 26; 17(12): 112389  \nDOI: 10.4330/wjc.v17.i12.112389 ISSN 1949-8462 (online)  \nCASE REPORT  \nCardiac sarcoidosis with a twist-active and fibrotic sarcoid with antiphospholipid positivity: A case report  \nSujoy Khasnavis, Sakul Sakul, Marko Novakovic, Paulus Adinugraha, Davendra Mehta  \nSpecialty type: Medicine, research and experimental  \nProvenance and peer review:  \nUnsolicited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B, Grade B, Grade B  \nNovelty: Grade B, Grade B, Grade B  \nCreativity or Innovation: Grade B, Grade B, Grade B  \nScientific Significance: Grade B, Grade B, Grade B  \nP-Reviewer: Cen K, Academic Fellow, Associate Chief Physician, Malaysia; Tatar S, Associate Professor, Türkiye  \nReceived: July 31, 2025  \nRevised: September 7, 2025  \nAccepted: November 7, 2025  \nPublished online: December 26, 2025  \nProcessing time: 147 Days and 6.3 Hours  \nSujoy Khasnavis, Department of Medicine, Jacobi North Central Bronx Hospital, Bronx, NY 10467, United States  \nSakul Sakul, Marko Novakovic, Paulus Adinugraha, Davendra Mehta, Department of Cardiology, Mount Sinai Morningside, New York, NY 10025, United States  \nCorresponding author: Sujoy Khasnavis, Researcher, Department of Medicine, Jacobi North Central Bronx Hospital, 111 East 210th Street, Bronx, NY 10467, United States.  \n[sujoy.khasnavis@gmail.com](sujoy.khasnavis@gmail.com)  \nAbstract  \nBACKGROUND  \nCardiac sarcoidosis (CS) is an infiltrative disease with manifestations such as nonsustained ventricular tachycardia (NSVT) and heart failure (HF) . Antiphospholipid syndrome (APS) and antiphospholipid positivity (APP) are prothrombotic phenomena which elevate risk for thromboembolism. CS with active systemic sarcoid and APS/APP is a rare combination of diseases.  \nCASE SUMMARY  \nA 54 year old male with HF presented with several cardiopulmonary symptoms. Chest imaging showed bilateral patchy and reticulonodular infiltrates. Subsequent lung biopsy confirmed pulmonary sarcoidosis. Positron emission tomography revealed active systemic sarcoidosis (SS) and fibrotic CS. Positive antiphospholipid antibodies without thromboembolism confirmed APP. HF and APP were managed with medical therapy. Fibrotic CS and NSVT required permanent cardiac device and antiarrhythmic therapy. SS was managed with early taper of steroids and transition to biologics.  \nCONCLUSION  \nFibrotic CS with active SS and APS/APP has not been previously described in literature. This case utilized a modified approach for the management of this combination of diseases. As immunosuppressants such as steroids have limited utility in fibrotic sarcoidosis and a potential for thromboembolic complications in the presence of APP, an accelerated transition to non-thrombotic immunosuppressants can be advantageous in the long term treatment of this combination of diseases.  \nKey Words: Fibrotic cardiac sarcoidosis; Active systemic sarcoidosis; Antiphospholipid  \n WJC  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 26, 2025  Volume 17  Issue 12   \nKhasnavis S et al. Cardiac sarcoidosis with antiphospholipid positivity  \npositivity; Accelerated steroid taper; Biologics; Antiplatelet therapy; Case report  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \nCore Tip: Fibrotic cardiac sarcoidosis with concomitant active systemic sarcoidosis and antiphospholipid positivity are unreported in literature. The various systemic manifestations of this combination of diseases require intricate medical management. As traditional immunosuppressants have limited utility in burnt sarcoidosis and concurrent antiphospholipid positivity raises risks for thromboembolic disease, essential management strategies include clos","cbCaipw1cEpvfZC1","https://ap.wps.com/l/cbCaipw1cEpvfZC1","pdf",9014362,"English","# Abstract\n## Background\n## Case Summary\n## Conclusion\n# Introduction\n# Case Report\n## Case Presentation\n## Management and Outcomes\n# Conclusion","[{\"question\":\"What rare disease combination is highlighted in this case report?\",\"answer\":\"Fibrotic cardiac sarcoidosis coexisting with active systemic sarcoidosis and antiphospholipid syndrome/antiphospholipid positivity is presented as a rare combination not previously described in the literature.\"},{\"question\":\"How was active systemic sarcoidosis and fibrotic cardiac sarcoidosis identified?\",\"answer\":\"Chest imaging and lung biopsy confirmed pulmonary sarcoidosis, while positron emission tomography demonstrated active systemic sarcoidosis and fibrotic cardiac sarcoidosis.\"},{\"question\":\"How were antiphospholipid positivity and heart failure managed?\",\"answer\":\"Positive antiphospholipid antibodies without thromboembolism confirmed APP, and heart failure with APP was managed with medical therapy; fibrotic CS and nonsustained ventricular tachycardia required a permanent cardiac device and antiarrhythmic therapy.\"}]","Cardiac sarcoidosis with a twist-active and fibrotic sarcoid with antiphospholipid positivity - A case report | PDF",1790564236,25]