Systemic transtiretin amyloidosis in the elderly patient with recurrent pleural effusions
- Authors: Boldueva S.A.1, Evdokimov D.S.1, Shvets N.S.1, Shahbazyan A.V.1, Kalinina E.Y.2, Mitrofanova L.B.3
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- Saint-Petersburg State Pediatric Medical University
- Almazov National Medical Research Centre
- Issue: Vol 13, No 3 (2021)
- Pages: 91-98
- Section: Case report
- URL: https://journals.rcsi.science/vszgmu/article/view/79512
- DOI: https://doi.org/10.17816/mechnikov79512
- ID: 79512
Cite item
Abstract
Systemic amyloidosis is a group of diseases associated with extracellular deposition of fibrillar proteins, which leads to a loss of normal organ structure and function. Transthyretin amyloidosis occurs with the deposition of amyloid, consisting of transthyretin transport protein, and can be a genetic or degenerative disease of senility (acquired from the deposition of wild-type transthyretin).
The article describes the clinical case of transthyretine amyloidosis in elderly patient, manifested by recurrent pleural effusions and biventricular heart failure demonstrating the complexity of timely diagnosis of wild-type transthyretin amyloidosis.
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##article.viewOnOriginalSite##About the authors
Svetlana A. Boldueva
North-Western State Medical University named after I.I. Mechnikov
Email: svetlanaboldueva@mail.ru
ORCID iD: 0000-0002-1898-084X
Scopus Author ID: 6506877971
MD, Dr. Sci. (Med.), Professor
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Dmitriy S. Evdokimov
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: kasabian244@gmail.com
ORCID iD: 0000-0002-3107-1691
аспирант кафедры факультетской терапии
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Natalia S. Shvets
North-Western State Medical University named after I.I. Mechnikov
Email: natashashvets@yandex.ru
MD, Cand. Sci. (Med.)
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Anahit V. Shahbazyan
North-Western State Medical University named after I.I. Mechnikov
Email: shahbazyananahit13@gmail.com
ORCID iD: 0000-0002-6923-5321
врач-кардиолог
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Elena Yu. Kalinina
Saint-Petersburg State Pediatric Medical University
Email: drkalinina@yandex.ru
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgLyubov B. Mitrofanova
Almazov National Medical Research Centre
Email: lubamitr@yandex.ru
MD, Dr. Sci. (Med.), Assistant Professor
Russian Federation, Saint PetersburgReferences
- Quarta CC, Solomon SD, Uraizee I, et al. Left ventricular structure and function in transthyretin-related versus light-chain cardiac amyloidosis. Circulation. 2014;129(18):1840–1849. doi: 10.1161/CIRCULATIONAHA.113.006242
- Connors LH, Sam F, Skinner M, et al. Heart failure resulting from age-related cardiac amyloid disease associated with wild-type transthyretin: a prospective, observational Cohort Study. Circulation. 2016;133(3):282–290. doi: 10.1161/CIRCULATIONAHA.115.018852
- Boldueva SA, Petrova VB, Khavinson VKh, et al. Problems in the diagnostics and treatment of transtiretinum amyloidosis with heart disease in the elderly: clinical experience. Advances in Gerontology. 2019;32(1–2):137–144. (In Russ.)
- Castaño A, Drachman BM, Judge D, Maurer MS. Natural history and therapy of TTR-cardiac amyloidosis: emerging disease-modifying therapies from organ transplantation to stabilizer and silencer drugs. Heart Fail Rev. 2015;20(2):163–178. doi: 10.1007/s10741-014-9462-7
- Sultan AM, Edwards WD, Mohammed SF, et al. Cardiac amyloid deposition is common in elderly patients with heart failure and preserved ejection fraction. Circulation. 2010;122:A17926.
- Tanskanen M, Peuralinna T, Polvikoski T, et al. Senile systemic amyloidosis affects 25% of the very aged and associates with genetic variation in alpha2-macroglobulin and tau: a population-based autopsy study. Ann Med. 2008;40(3):232–239. doi: 10.1080/07853890701842988
- Poliakova AA, Semernin EN, Sitnikova MY, et al. Transthyretin amyloidosis in a cohort fold and very old patients with chronic heart failure. Kardiologiia. 2018;58(S2):12–18. (In Russ.). doi: 10.18087/cardio.2390
- Dyudina IA. Transtyretin amyloidosis: the current state of the problem. Heart failure and comorbid conditions.2017;1:63–68. (In Ukraine)
- Dubrey SW, Hawkins PN, Falk RH. Amyloid diseases of the heart: assessment, diagnosis, and referral. Heart. 2011;97(1):75–84. doi: 10.1136/hrt.2009.190405
- Fernandes A, Caetano F, Almeida I, et al. Diagnostic approach to cardiac amyloidosis: A case report. Amiloidose cardíaca – a bordagem diagnóstica, a propósito de um casoclínico. Rev Port Cardiol. 2016;35(5):305.e1–305.e7. doi: 10.1016/j.repc.2016.01.004
- Lysenko (Kozlovskaya) LV, Rameev VV, Moiseev S, et al. Clinical guidelines for diagnosis and treatment of systemic amyloidosis. Klinicheskaya farmakologiya i terapiya. 2020;(1):13–24.(In Russ.). DOI: 10.32756/ 0869-5490-2020-1-13-24
- Berk JL. Pleural effusions in systemic amyloidosis. Curr Opin Pulm Med. 2005;11(4):324–328. doi: 10.1097/01.mcp.0000162378.35928.37
- Mansalis KA, Klein DA, Demartini SD, et al. Pleural findings in a patient with persistent pulmonary effusions from systemic amyloidosis. Amyloid. 2011;18(1):29–31. doi: 10.3109/13506129.2010.537156