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A case of systemic amyloidosis with multiple myeloma proceeded by pulmonary amyloidosis diagnosed after developing cardiac failure with cardiac amyloidosis
Annual Conference on HEART DISEASES
September 18-19, 2017 | Toronto, Canada
Mitsutaka Nakashima
Iwakuni Clinical Center, Japan
Posters & Accepted Abstracts : Curr Trend Cardiol
Abstract:
A 70-year-old male complained exertional dyspnea. Chest X-ray and computed tomographic scanning showed left pleural effusion. Diuretic and antibacterial therapy started but his pleural effusion remained. Biopsy by videoassisted thoracoscopic surgery was performed, and its pathological fingings showed deposition of amyloid protein at alveolar walls and vascular walls in left upper lung. So, he was diagnosed as localized pulmonary amyloidosis at first. After three months, he complained recurrence of exertional dyspnea and leg edema. Chest X-ray computed tomographic scanning showed bilateral pleural effusion. Ultrasound cardiography showed left ventricular dysfunction and hypertrophy. So, he was considered as complicating cardiac amyloidosis. Althrough cardiac biopsy didn’t show amyloid protein, clinical fingings such as left ventricular hypertrophy consistent with cardiac amyloidosis. In addition, upper gastrointestinal tract biopsy also showed amyloid protein, so he was diagnosed as systemic amyloidosis including cardiac symptoms. Bone marrow biopsy performed in order to identify the underlying disease of systemic amyloidosis showed abnormal plasma cells, so he was finally diagnosed as multiple myeloma that caused systemic amyloidosis. In this seminar, I will show this rare case report in that pulmonary amyloidosis preceded other organs in systemic amyloidosis. We firstly diagnosed as localized lung amyloidosis, but after cardiac failure combined we finaly could diagnosed as systemic amyloidosis with multiple myeloma.
Biography:
Mitsutaka Nakashima is an expert in the diagnosis and treatment of cardiovascular diseases, including hypertension, dyslipidemia, atherosclerosis, peripheral arterial disease, coronary artery disease, arrythmia and pulmonary hypertension. He graduated Okayama University Medical School in 2013. He subsequently completed his residency of cardiology at Hiroshima City Hospital and Okayama Medical Center. He is currently the staff of Dep. Of Cardiovascular medicine at Iwakuni Clinical Hospital, Yamaguchi, Japan. His clinical interests include the diagnosis and treatment of heart failure and pulmonary hypertension.
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