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. 2022 Nov;38(6):806-809.
doi: 10.6515/ACS.202211_38(6).20220425B.

Two Kinds of Cardiac Amyloidosis in One Patient: A Case Report

An-Li Yu  1 , Cheng-Hsuan Tsai  2 , Chi-Chao Chao  3 , Chia-Tung Shun  4   5 , Yen-Hung Lin  1
Affiliations

Two Kinds of Cardiac Amyloidosis in One Patient: A Case Report

An-Li Yu et al. Acta Cardiol Sin. 2022 Nov.
No abstract available

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Figures

Figure 1
Figure 1
(A) Electrocardiogram showed sinus rhythm, poor R-wave progression, nonspecific ST-T changes and QS pattern at V1-V3. (B) Coronary angiography showed patent coronary arteries. (C) Transthoracic echocardiogram of parasternal long axis view with M-mode showed left ventricular hypertrophy (17 mm in the basal septum and 15 mm in the posterior wall). (D) Duplex of mitral inflow showed mitral valve (MV) peak E 49.4 cm/s and MV peak A 62.2 cm/s, indicating diastolic dysfunction. (E) Global longitudinal strain showed reduced longitudinal systolic strain with apical sparing. (F) Cardiac magnetic resonance (CMR) with post-contrast image showed diffuse subendocardial late gadolinium enhancement (arrow). (G) CMR with pre-contrast T1 image of short axis view showed a significantly elevated T1 signal to 1,022 ms. (H) CMR with extracellular volume fraction (ECV) maps of short axis view showed increased ECV to 42.2%. (I) 99mTc-PYP scintigraphy with single photon emission computed tomography(SPECT)/computed tomography (CT) confirmed radiotracer uptake in the myocardium. (J) 99mTc PYP scintigraphy with SPECT showed moderate cardiac uptake equal to bone with mildly attenuated bone uptake, which was classified as grade 2 according to the Semi-quantitative Visual Grading of Myocardium system. (K) The heart-to-contralateral lung ratio was 1.4569.
Figure 2
Figure 2
Endomyocardial biopsy of the right ventricular was done. (A, B & C) Immunohistochemistry of kappa light chain revealed kappa deposition located at perivascular areas (arrowheads). (D, E & F) Immunohistochemistry of monoclonal-transthyretin revealed transthyretin deposition in the myocardium (arrows).
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References

    1. Sidiqi MH, McPhil ED, Theis JD, et al. Two types of amyloidosis presenting in a single patient: a case series. Blood Cancer J. 2019;9:30. - PMC - PubMed
    1. Jhaveri T, Sarosiek S, Ruberg FL, et al. Once AL amyloidosis: not always AL amyloidosis. Amyloid. 2018;25:139–140. - PubMed
    1. Mahmood S, Gilbertson JA, Rendell N, et al. Two types of amyloid in a single heart. Blood. 2014;124:3025–3027. - PMC - PubMed
    1. Koba S, Inoue T, Otu M, et al. The occurrence of two types of amyloid in the same patient. Br J Dermatol. 2008;158:860–862. - PubMed
    1. Tanskanen M, Peuralinna T, Polvikoski T, et al. Senile systemic amyloidosis affects 25% of the very aged and associates with genetic variation in alpha2-macroglobulin and tau: a population-based autopsy study. Ann Med. 2008;40:232–239. - PubMed

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