Biopsy Evidence of Sequential Transthyretin and Immunoglobulin Light-Chain Cardiac Amyloidosis in the Same Patient.

在同一患者中序贯转甲状腺素和免疫球蛋白轻链心脏淀粉样变性的活检证据。

• 发表时间: Mar 2021
• 来源期刊: JACC Case Rep
• DOI: 10.1016/j.jaccas.2020.12.047
• PMID: 34317556
• 文章类型: Case Reports
• 作者列表: Vergaro G,Castiglione V,Poletti R,Buda G,Pucci A,Musetti V,Genovesi D,Aimo A,Passino C,Emdin M

关键词: 99mTc-HMDP, 99mTc-hydroxymethylene diphosphonate; AL amyloidosis; AL, immunoglobulin light-chain amyloidosis; ATTR amyloidosis; ATTR, transthyretin amyloidosis; CA, cardiac amyloidosis; CMR, cardiac magnetic resonance; HF, heart failure; Ig, immunoglobulin; LV, left ventricular; LVEF, left ventricular ejection fraction; NT-proBNP, N-terminal pro–B-type natriuretic peptide; cardiac amyloidosis; hs-cTnT, high-sensitivity cardiac troponin T

Abstract

Currently adopted diagnostic flow charts consider transthyretin and light-chain cardiac amyloidosis as mutually exclusive. Here, we report for the first time, to our knowledge, the demonstration of a biopsy-proven dual pathology in an 80-year-old man with sequential development of both wild-type transthyretin amyloidosis and light-chain cardiac amyloidosis cardiomyopathy over a 3-year timespan. (Level of Difficulty: Intermediate.).

摘要

目前采用的诊断流程图认为运甲状腺素蛋白和轻链心脏淀粉样变性是相互排斥的。这里,我们第一次报道，根据我们的知识，在一名80岁的男性患者中,显示活检证实的双重病理,在3年的时间内连续发展为野生型甲状腺素运载蛋白淀粉样变性和轻链心脏淀粉样变性心肌病.（难度等级：中级。).