DOI: https://doi.org/10.22263/2312-4156.2024.2.69
A.A. Dyachkova, L.A. Avtaykina
Primary AL amyloidosis (Lambda chain ++) with the damage to the kidneys, heart, thyroid gland (clinical case)
National Research Mordovian State University named after N.P. Ogarev, Saransk, Russian Federation
Vestnik VGMU. 2024;23(2):69-76.
Abstract.
Primary amyloidosis is characterized by a varied clinical picture, but predominantly affects the kidneys and the heart. The debut of this pathology can be disguised as the initial manifestations of other diseases, in connection with this, patients see specialists of various profiles (a therapist, a cardiologist, etc.), and not a rheumatologist, whose competence is the diagnosis and treatment of the disease.
This article presents the analysis of a clinical case of primary amyloidosis (AL type) with predominant damage to the kidneys, the heart and thyroid gland in a 66-year-old woman. This patient had a clinical picture characteristic of amyloidosis and changes while using laboratory and instrumental investigation methods. However, the diagnostic search was complicated by cardiac damage masking itself as hypertensive cardiomyopathy, which led to the erroneous assumption of the presence of a variant of amyloidosis associated with multiple myeloma due to the existing signs of nephropathy. Timely diagnosis and administration of rational treatment resulted in a decrease of the pathological process activity and stabilization of the patient’s condition.
The complexity of the diagnostic search in this clinical case indicates the need for increased attention of practicing physicians and requires an individual approach to the management of each patient in order to minimize making an erroneous diagnosis and reducing the volume of additional examination methods.
Keywords: AL amyloidosis, primary amyloidosis, restrictive cardiomyopathy.
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Information about authors:
A.A. Dyachkova – Candidate of Medical Sciences, associate professor of the Chair of Faculty Therapy with the course of Medical Rehabilitation of the Medical Institute, National Research Mordovian State University named after N.P. Ogarev, https://orcid.org/0000-0002-4596-2970
L.A. Avtaykina – the fourth-year student of the specialty “General Medicine” of the Medical Institute, National Research Mordovian State University named after N.P. Ogarev, https://orcid.org/0009-0002-3473-5200
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Lyubov A. Avtaykina.
