[Obstructive cardiomyopathy, caused by amyloidosis, associated with bone marrow myeloma].
A case of a 40-year-old female is reported. Her symptoms started with abdominal complaints, loss of weight, general weakness, then gradually polyneuropathy, worsening hypotonia and systolic heart murmur developed. The bone marrow showed 20-25% infiltration by myeloma. An IgG lambda type paraproteinaemia was diagnosed using immunelectrophoresis. The ejection systolic murmur was caused by restrictive cardiomyopathy--characteristic of primary amyloidosis--with obstruction of the outflow tract of the left ventricle. Echocardiographic changes took 11 months to develop. The patient's status became dominated by severe hypotonia and she died as a result of heart failure. The post mortem examination confirmed amyloidosis with myeloma. Histopathological examination of the myocardium, coronary and other arteries revealed severe changes with AL-type amyloid deposits. The case demonstrates that amyloidosis can lead not only to restrictive cardiomyopathy but obstruction of the outflow tract of the left ventricle.
Nyíregyháza III. sz. Belgyógyászati Osztály/Kardiológia. Szabolcs-Szatmár-Bereg megyei Onkormányzat Jósa András Kórház Rendelöintézet.
M
M
Rusznák
J
J
Jakó
M
M
Francz
T
T
Babicz
D000328:Adult; D000686:Amyloidosis / Q000150:complications* / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000209:etiology / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D009101:Multiple Myeloma / Q000150:complications* / Q000276:immunology / Q000473:pathology; D010265:Paraproteinemias / Q000276:immunology
D007074:Immunoglobulin G
Csontvelöi myelomához társult amyloidosis által okozott obstructiv cardiomyopathia.