[Diagnosis and the treatment of primary amyloidosis].
BACKGROUND
Primary amyloidosis belongs to a group of monoclonal plasma cell disorders, characterized by extracellular deposition of immunoglobulin light chain fibrils in various tissues and subsequent multiorgan dysfunction.


METHODS
We present a 51-year-old female with 2-years history of fatigue on exertion, oedema of face, abdomen and legs, bone pain and obstipation. After diagnostic procedures such as electrophoresis and immunoelectrophoresis of serum and urine proteins, immunohistohemical staining of bone marrow biopsy specimens and Congo red staining of rectal biopsy specimens, the patient received misdiagnosis of multiple myeloma and was referred to our hospital for further treatment. We reevaluated and complemented diagnostic procedures (ehocardiosonography and biopsy of subcutaneaus tissue with Congo red staining), and established diagnosis of primary amyloidosis. The therapy had started with intravenous (i.v.) melphalan and dexamethasone (totally eight cycles) and continued with peroral melphalan and i.v. dexamethasone. Stabilization of the disease was achieved after 35 months of the treatment.


CONCLUSIONS
The case of this rare and often fatal disease emphasizes significance of early diagnosis and, consequently, initiation of specific therapies which are indispensable to improve the disease prognosis.
Djunić
Irena
I
Klinicki centar Srbije, Institut za hematologiju, Beograd, Srbija. irenadju@eunet.rs
Tomin
Dragica
D
Perunicić
Maja
M
Vidović
Ana
A
Cemerikić
Vesna
V
Djurasinović
Vladislava
V
Jaković
Ljubomir
L
Janković
Gradimir
G
D000686:Amyloidosis / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged