Angina symptoms as the first manifestation of al-type amyloidosis. What should be the diagnostic approach?
General Medicine, 2024, 26(3), 29-32.
A. Garev1, B. Stoimenov1, R. Pancheva1, R. Filev2, N. Runev1
1 Internal Medicine Propedeutics Clinic, UMHAT „Alexandrovska“, Department of Propedeutics of Internal Diseases, Faculty of Medicine, Medical University ‒ Sofia
2 Second Internal Clinic, Department of Nephrology, UMHAT „Sv. Anna“, Department of Internal Medicine, Faculty of Medicine, Medical University ‒ Sofia
Abstract. Amyloidosis is a disease associated with accumulation and deposition of amyloid in the walls of capillaries and internal organs. Depending on the composition of amyloid substances, it is mainly divided into primary (AL), secondary (AA), familial (TTR) and wild type. The subclinical course, diffuse organ involvement and various symptoms that often overlap with those of other diseases predispose to underestimation of this disease and delay in its diagnosis and treatment. Due to the prominent health and economic aspect of amyloidosis and the possibilities of specific therapy, we present a clinical case of a 66-year-old female patient with proven AL type amyloidosis, currently undergoing treatment with Velcade, with a good therapeutic response. The symptoms of the patient’s disease began in 2018, and their atypical nature and evolution posed a challenge to cardiologists, nephrologists and hematologists. Timely diagnosis, however, made it possible to start effective targeted cytostatic treatment.
Key words: amyloidosis, transthyretin, restrictive cardiomyopathy
Address for correspondence: Alexandar Garev, MD, e-mail: leksgarev@abv.bg