Primary amyloidosis with pulmonary involvement which presented exudative pleural effusion and high fever.
We describe here an extremely rare case of primary amyloidosis which presented moderate pleural effusion and high fever. A 71-year-old man was admitted to our hospital because of exertional dyspnea, fatigue and fever. A chest X-ray showed right-sided moderate pleural effusion. A thoracocentesis revealed an exudative pleural effusion. Cytology and cultures of the effusion were negative. External drainage failed to control the effusion. To determine the etiology of the effusion and fever, bronchoscopy was performed. Biopsies of the tracheal wall showed amyloid deposition. The pleural effusion might have been due to the inflammation and the disturbed lymphatic drainage caused by the amyloid deposition. Treatment with melphalan (6 mg) and prednisolone (35 mg) for 4 days every 6 weeks decreased the fever and alleviated his symptoms.
Fujimoto
Naoki
N
First Department of Internal Medicine, Mie University School of Medicine, Tsu.
Masuoka
Hiroshi
H
Kosaka
Hiroko
H
Ota
Satoshi
S
Ito
Masaaki
M
Nakano
Takeshi
T
D000368:Aged; D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001999:Bronchoscopy; D004417:Dyspnea / Q000209:etiology; D005122:Exudates and Transudates; D005334:Fever / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D010996:Pleural Effusion / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D018906:Antineoplastic Agents, Alkylating; D011239:Prednisolone; D008558:Melphalan