title: (99m)Tc-HMDP scintigraphy rectifies wrong diagnosis of AL amyloidosis.
abstract: A 71-year-old African man without history of cardiac disease was referred to our center for dyspnea. Transthoracic echocardiogram and cardiac MRI were suggestive of cardiac amyloidosis (CA). The diagnosis of the light-chain cardiac amyloidosis (AL-CA) was made after a first endomyocardial biopsy. Accordingly chemotherapy was started. Systematic 99mTc-HMDP scintigraphy showed moderate cardiac uptake (visual score of 2), unusual for AL-CA, and permitted to rectify the diagnosis. Hereditary transthyretin cardiac amyloidosis was confirmed by a second endomyocardial biopsy with a positive Congo-red and anti-transthyretin antibody stainings, mass spectrometry and genetic analysis (Val122Ile mutation).
authors.affiliation: UPEC, 94000, Créteil, France, agalat@hotmail.fr.
authors.forename: Arnault
authors.initials: A
authors.lastname: Galat
authors.forename: Axel
authors.initials: A
authors.lastname: Van Der Gucht
authors.forename: Magali
authors.initials: M
authors.lastname: Colombat
authors.forename: David
authors.initials: D
authors.lastname: Attias
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Itti
authors.forename: Michel
authors.initials: M
authors.lastname: Meignan
authors.forename: Fabien
authors.initials: F
authors.lastname: Lebras
authors.forename: Valérie
authors.initials: V
authors.lastname: Molinier-Frenkel
authors.forename: Nicole
authors.initials: N
authors.lastname: Benhaiem
authors.forename: Aziz
authors.initials: A
authors.lastname: Guellich
authors.forename: Jean
authors.initials: J
authors.lastname: Rosso
authors.forename: Thibaud
authors.initials: T
authors.lastname: Damy
mesh_terms: D000368:Aged; D028226:Amyloidosis, Familial / Q000000981:diagnostic imaging* / Q000235:genetics*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000235:genetics*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*
chemical_list: D019275:Radiopharmaceuticals; C052435:technetium Tc 99m (Sn) hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate