title: Congestive heart failure: a case of protein misfolding.
abstract: This article describes an interesting case of a patient presenting with congestive heart failure found to have restrictive cardiomyopathy with initial laboratory evaluation showing hypogammaglobuminemia without a monoclonal band on serum and urine electrophoresis. This case highlights the clinically significant cardiac manifestation caused by protein misfolding, a defect in protein homeostasis. In addition, the utility of a relatively newer laboratory test, serum free light chains as well as the importance of clinical and pathophysiologic correlation is also discussed. We present a relatively uncommon cause of heart disease, cardiac amyloidosis in a patient with a systemic plasma cell dyscrasia, and multiple myeloma.
authors: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (CH).
authors: Chung-Eun
authors: CE
authors: Ha
authors: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (CH).
authors: Nadhipuram V
authors: NV
authors: Bhagavan
authors: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (CH).
authors: Miki
authors: M
authors: Loscalzo
authors: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (CH).
authors: Stephen K
authors: SK
authors: Chan
authors: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (CH).
authors: Huy V
authors: HV
authors: Nguyen
authors: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (CH).
authors: Carlos N
authors: CN
authors: Rios
authors: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (CH).
authors: Stacey A A
authors: SA
authors: Honda
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis / Q000209:etiology*; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D009101:Multiple Myeloma; D057165:Proteostasis Deficiencies / Q000150:complications* / Q000175:diagnosis
keywords: cardiac amyloidosis; congestive heart failure; light chains; multiple myeloma; serum free