DOI QR코드

DOI QR Code

Pericardial Amyloidosis Associated with Light-chain Myeloma

가벼운 사슬 골수종과 동반된 심장막 아밀로이드증

  • Chang, Je Ho (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Chang, Sun Hee (Department of Pathology, Inje University Ilsan Paik Hospital) ;
  • Huh, Jin Won (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Lee, Sung Yun (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Kim, Jung A (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Yoon, Seong Min (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Lee, Hye Ran (Department of Internal Medicine, Inje University Ilsan Paik Hospital)
  • 장재호 (인제대학교 일산백병원 내과학교실) ;
  • 장선희 (인제대학교 일산백병원 병리과교실) ;
  • 허진원 (인제대학교 일산백병원 내과학교실) ;
  • 이성윤 (인제대학교 일산백병원 내과학교실) ;
  • 김정아 (인제대학교 일산백병원 내과학교실) ;
  • 윤성민 (인제대학교 일산백병원 내과학교실) ;
  • 이혜란 (인제대학교 일산백병원 내과학교실)
  • Received : 2008.07.01
  • Accepted : 2008.09.02
  • Published : 2013.05.01

Abstract

Amyloidosis is characterized by the deposition of amyloid fibrils, which cause both functional and structural damage to organs. Cardiac involvement with amyloids is a common cause of secondary cardiomyopathy and leads to congestive heart failure. Pericardial amyloidosis usually occurs at the late or terminal stage of the disease after myocardial involvement, but it is extremely rare for pericardial amyloidosis to proceed with myocardial involvement. Here, we report a rare case of a 66-year-old patient with light-chain myeloma, who presented with pericardial effusion but no evidence of cardiomyopathy.

Keywords

References

  1. Sipe JD, Cohen AS. Amyloidosis. In: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, eds. Harrison's Principles of Internal Medicine. 16th ed. NewYork: McGraw-Hill, 2005, chapter 310, 2024-2029.
  2. Kornberg A, Rapoport M, Yona R, Kaufman S. Amyloidosis of the pericardium in multiple myeloma: an unusual cause of bloody pericardial effusion. Isr J Med Sci 1993; 29:794-797.
  3. Comenzo RL, Zhang Y, Martinez C, Osman K, Herrera GA. The tropism of organ involvement in primary systemic amyloidosis: contributions of Ig V(L) germ line gene use and clonal plasma cell burden. Blood 2001;98:714-720. https://doi.org/10.1182/blood.V98.3.714
  4. Falk RH, Comenzo RL, Skinner M. The systemic amyloidoses. N Engl J Med 1997;337:898-909. https://doi.org/10.1056/NEJM199709253371306
  5. Abraham RS, Geyer SM, Price-Troska TL, et al. Immunoglobulin light chain variable (V) region genes influence clinical presentation and outcome in light chain-associated amyloidosis (AL). Blood 2003;101:3801-3808. https://doi.org/10.1182/blood-2002-09-2707
  6. Rosenbaum H, Hoffman R, Carter A, et al. Multiple myeloma with pericardial involvement and cardiac tamponade: a report of three patients. Leuk Lymphoma 1996;24:183-186. https://doi.org/10.3109/10428199609045727
  7. Arat M, Ulusoy V, Demirer T, et al. An unusual presentation of plasma cell dyscrasias: cardiac tamponade due to myelomatous infiltration. Leuk Lymphoma 2002;43:145-148. https://doi.org/10.1080/10428190210182
  8. Goldberg E, Mori K. Multiple myeloma with isolated visceral (epicardial) involvement and cardiac tamponade. Chest 1970;57:584-587. https://doi.org/10.1378/chest.57.6.584
  9. Maeno T, Sando Y, Tsukagoshi M, et al. Pleural amyloidosis in a patient with intractable pleural effusion and multiple myeloma. Respirology 2000;5:79-80. https://doi.org/10.1046/j.1440-1843.2000.00230.x
  10. Shah KB, Inoue Y, Mehra MR. Amyloidosis and the heart: a comprehensive review. Arch Intern Med 2006;166: 1805-1813. https://doi.org/10.1001/archinte.166.17.1805
  11. Barosi G, Boccadoro M, Cavo M, et al. Management of multiple myeloma and related-disorders: guidelines from the Italian Society of Hematology (SIE), Italian Society of Experimental Hematology (SIES) and Italian Group for Bone Marrow Transplantation (GITMO). Haematologica 2004;89:717-741.