[Heart failure and arterial hypertension disclosing amyloidosis].
Amyloidosis results from protein infiltration of the extracellular space of organs and tissues. Several amyloidosis proteins have been identified. Protein AL, (deriving from immunoglobulin light chain), protein AA and prealbumin are the most involved in this disease. When AL amyloidosis involves the heart, the illness is often terminal. Most clinical symptoms are heart failure and arrhythmia or block conduction. This case was characterised by the unusual combination of hypertension and amyloidosis. The diagnosis suggested by the echocardiographic but was confirmed by the damaged organ's biopsy. The present case concerns a young woman, who has hypertension and a pulmonary oedema. The echocardiographic scan showed a septal hypertrophy with a shining and granite-like aspect which is compatible with heart amyloidosis. Systolic and diastolic disorder with mitral and aortic regurgitation were also revealed. The kidney and rectum biopsies confirmed amyloidosis AL of the Kappa dysglobulinemia type, without extraosseous plasmocytoma. The heart and kidney failure symptoms disappeared after treatment with diuretics and ACE inhibitors.
Habbal
R
R
Service de Cardiologie, CHU Ibn Rochd Casablanca, Maroc.
Noureddine
M
M
Hachim
K
K
Zahraoui
M
M
Azzouzi
L
L
Fadouach
S
S
Zaid
D
D
Chraibi
N
N
D000328:Adult; D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001205:Ascorbic Acid; D001706:Biopsy; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D003078:Colchicine / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology*; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D009393:Nephritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D010265:Paraproteinemias / Q000150:complications / Q000175:diagnosis; D011654:Pulmonary Edema / Q000209:etiology; D011859:Radiography; D012007:Rectum / Q000473:pathology
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D007145:Immunoglobulin kappa-Chains; D001205:Ascorbic Acid; D003078:Colchicine