Cardiac amyloidosis in a patient with multiple myeloma.

摘要

Amyloidosis is an infiltrative condition caused by extracellular deposits of amyloid which results from modified, insoluble proteins.The associated B lymphocyte dyscrasias in systemic amyloidosis (AL) include lymphoma, multiple myeloma and macroglobulinemia. Theamyloid fibrils are formed from monoclonal immunoglobulins light chains of both lambda (λ) and kappa (k) families, produced by proliferatedplasmocytes.We present the case of a patient with multiple myeloma (MM), who developed amyloidosis secondary to light chains depositswithin the myocardium. The main symptoms and signs were due to right sided heart failure. In order to confirm the diagnosis, imaging testwere performed (echocardiography and cardiac MRI) followed by oral mucosa tissue biopsy and subcutaneous abdominal fat by fine-needleaspiration. The diagnosis of multiple myeloma was established at the Hematology Clinic in Cluj-Napoca.