Author/Authors :
Yaghubi, Mohsen Department of Cardiac Surgery - Mashhad University of Medical Sciences, Mashhad, Iran , Dinpanah, Hossein Department of Emergency - Dey 9th Hospital - Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran , Ghanei-Motlagh, Fahimeh Department of Obstetrics and Gynecology - Dey 9th Hospital - Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran , Kakhki, Samaneh Department of Pharmacology - Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran , Ghasemi, Reza Department of Cardiology - Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
Abstract :
BACKGROUND: Amyloidosis is a severe systemic disorder produces by the accumulation of
inappropriately amyloid deposition in tissues. Cardiac involvement, as a main type of
amyloidosis, has a major impact on prognosis. We describe a biopsy-proven cardiac amyloidosis
in an old man with unexpected presentation.
CASE REPORT: A 70-year-old man, with a complaint of severe weakness, lightheadedness, and
lower limb paresthesia, was admitted to the emergency department. Electrocardiography
revealed right bundle branch block and Trifascicular block. Echocardiography study showed a
moderately increased thickness of left ventricular wall with concentric pattern as well.
Laboratory investigations including serum and urine electrophoresis, and serum free light chain
examination as immunofixation assay revealed that κ chains predominated over λ chains in a
ratio of 3:2. Our patient with final diagnosis of amyloid light-chain (AL) amyloidosis underwent
chemotherapy with melphalan combined with high-dose dexamethasone, CPHPC and
monoclonal antibodies for 2 weeks.
CONCLUSION: It shows that rapid diagnosis of AL amyloidosis can enhance the prognosis.
Applying an optimal strategy for the treatment leads to effective therapy, too.
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