title: Primary amyloidosis with pulmonary involvement which presented exudative pleural effusion and high fever.
abstract: 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.
authors.affiliation: First Department of Internal Medicine, Mie University School of Medicine, Tsu.
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masuoka
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kosaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ota
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakano
mesh_terms: 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
chemical_list: D000893:Anti-Inflammatory Agents; D018906:Antineoplastic Agents, Alkylating; D011239:Prednisolone; D008558:Melphalan