Abstract
Summary Background Systemic sarcoidosis can result in dramatic manifestations despite therapeutic escalation. Tumor necrosis factor (TNFα) has a key role in this disease and antagonists of TNFα have been successfully used as an alternative to conventional therapy. We report a case of refractory sarcoidosis with mediastinal, bone and ear, nose, throat (ENT) lesions. Methods In this patient we monitored response to treatment by infusions of the anti-TNFα antibody, infliximab, with fluorine 18-fluorodeoxyglucose positron emission tomography (FDG-PET). Results Early and spectacular response to infliximab was demonstrated by FDG-PET, which evidenced complete response to treatment. Conclusion This case supports use of FDG-PET to evaluate the extent of active disease in refractory sarcoidosis and above all, FDG-PET could be an imaging method of choice showing response to infliximab in refractory sarcoidosis earlier than other imaging techniques.
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