Matt Lander, MD: Understanding How Sarcoidosis Affects the Heart


According to older literature, most cases of sarcoidosis involve the lungs, but Dr. Matthew Lander explains why there could be more to the rare disease.

The granulomas associated with sarcoidosis often present in the lungs and lymph nodes leading to inhibited ariways, inflammation, and fibrosis of tissue, but the rare disease isn't restricted to just that.

In an interview with HCPLive, Matthew Lander, MD, Division of Advanced Heart Failure and Transplantation Cardiology, Cardiovascular Institute, Allegheny Health Network (AHN), shared his expertise with cardiac sarcoidosis.

Lander explained that there's much to be understood about the disease, but from a general perspective, tiny collections of cells present in the body and immune system that get exacerbated, and the reasons why are not entirely known.

"It's not really understood if these are from environmental exposures, occupational exposures, if there is an infectious process that leads to this exuberant response of the immune system to develop these," he said. "We know that the disease process of sarcoidosis can affect multiple different organs, primarily the lungs, but I think as we all go forward and have more unique abilities to image different parts of the body, we feel like we're finding, more and more, potentially isolated disease in other areas."

Most cases of sarcoidosis are handled by pulmonologists because almost all cases stem from the lungs, at least according to older literature, Lander explained. Overall, the disease still relatively poorly understood.

Only 10%-15% of cases involve the heart, he said. However, the severity of disease, along with the intensity of treatment required for these patients is notable. Lander views it as a multidisciplinary disease.

He acknowledged a few things to look out for, but specifically he pays attention to is volume retention issues.

"Sometimes people get put on prednisone, somewhat unnecessarily, even just for a week or 2, and that can be very significant for them, prednisone can lead to increased hunger drive, increased thirst, drive fluid retention," Lander explained. "So, in a very short period of time, if someone with heart failure is on prednisone, it can lead to heart failure exacerbation, soo the volume aspect is probably the biggest issue."

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