International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 5, Issue 6 | Case Report | Open Access
Yash Ranga*
Yash Ranga1*, Cheryl Jain2, Aayush Anand3, Bryan Ashong3, Riddhi Agarwal4, Venkata Peddi5, Abhishek Ranga1, Bharti Chura6
1Jawahar Lal Nehru Medical College, Ajmer, India
2MBBS, Jawaharlal Nehru medical College, Ajmer, India
3University of Texas at San Antonio
4University of South Florida, Tampa, United States
5Nil Ratan Sircar Medical College, Kolkata, India
1Cleveland Clinic, Cleveland, United States
6Maharaja Ganga Singh University, Bikaner
*Correspondence to: Yash Ranga
Fulltext PDFBackground: Sarcoidosis is a multisystem granulomatous disorder that predominantly affects the lungs, though extrapulmonary involvement significantly increases morbidity. The simultaneous triad of pulmonary, cardiac, and bone marrow sarcoidosis is exceptionally rare, with fewer than five cases documented in medical literature. This report describes a unique case of tri-organ disseminated sarcoidosis in an elderly patient, highlighting the 'diagnostic ceiling' that often complicates the recognition of systemic disease in older populations.
Case Presentation: A 73-year-old female with known Stage I pulmonary sarcoidosis presented with hypoxic respiratory failure and pancytopenia. Diagnostic imaging revealed progressive pulmonary infiltrates and, via cardiac PET (SUV 6.7), occult cardiac involvement-a modality necessitated by MRI-incompatible hardware. Histological confirmation of disseminated disease was obtained through bone marrow biopsy, which showed non-caseating granulomas. This rare tri-organ manifestation was treated with dual-therapy prednisone and infliximab, resulting in clinical stabilization and a transition to a six-month steroid taper.
Discussion: Simultaneous tri-organ sarcoidosis is exceedingly rare and carries a high mortality risk due to cardiac and hematologic complications. This case demonstrates that when traditional imaging is contraindicated, multimodality assessment with PET and bone marrow biopsy is essential for identifying disseminated disease. Given the severity of cardiac and marrow involvement, early initiation of infliximab alongside corticosteroids may be superior to traditional steroid-sparing agents. Clinicians must maintain a high index of suspicion for systemic sarcoidosis in older patients presenting with new-onset cytopenias or cardiac symptoms.
Sarcoidosis; Cardiac Sarcoidosis; PET-CT; Bone-Marrow Sarcoidosis; Case Report
Yash Ranga, Cheryl Jain, Aayush Anand, Bryan Ashong, Riddhi Agarwal, Venkata Peddi, et al. A Rare Triad of Disseminated Sarcoidosis Involving The Heart, Lungs, And Bone Marrow: A Case Report. Int Clinc Med Case Rep Jour. 2026;5(6):1-10.