Table 5.

Japanese ministry of health and welfare guidelines for CS from 2006 (37).

Diagnostic category	Criteria	Comments
Histologic diagnosis	Endomyocardial biopsy demonstrates noncaseating epithelioid cell granulomata with histological or clinical diagnosis of extracardiac sarcoidosis
Clinical diagnosis group*	• Negative endomyocardial biopsy • Presence of histologic or clinical extracardiac sarcoid
Major clinical criteria	Advanced atrioventricular block	• Unclear what constitutes “advanced” (II? III?) or if paroxysmal block is included • First-degree block also commonly seen in CS**
	Basal thinning of the interventricular septum	• Imaging modality not specified (Echo? MR? Nuclear imaging?) • Specific thickness not specified (11 mm? 12 mm?)
	Positive cardiac gallium uptake	• Not used commonly—now routinely replaced by PE
	Depressed left ventricular ejection fraction (<50%)	• Modality not specified
Minor clinical criteria	Abnormal ECG findings	• Ventricular arrhythmias • Right bundle branch block • Axis deviation • Abnormal Q-wave • Atrial arrhythmias (sinus tachycardia or sinus exit block) commonly seen in CS excluded
	Abnormal echocardiography	• Regional wall motion abnormalities • Morphologic abnormality • Valvular abnormalities excluded • Pericardial abnormalities excluded
	Nuclear perfusion defect detected	• Reverse perfusion pattern (commonly seen) excluded
	Delayed gadolinium enhancement noted on cardiac MRI	• Localization and early enhancement not mentioned
	Endomyocardial biopsy showing interstitial fibrosis or monocyte infiltration over moderate grade	• “Moderate grade” not defined

^*Requires two or more major criteria, or one major criterion and two or more minor criteria.

^**CS, cardiac sarcoidosis.