Pennisi Manuela, Lanza Giuseppe, Vitello Girolamo Aurelio, Faro Denise Cristiana, Fisicaro Francesco, Cappellani Francesco, Bella Rita, Monte Ines Paola
Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 89, 95123 Catania, Italy.
Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy.
Life (Basel). 2023 Dec 7;13(12):2305. doi: 10.3390/life13122305.
Clinically, there is considerable heterogeneity in the presentation of transthyretin amyloidosis (ATTR), which ranges from primarily cardiac and primarily neurologic to mixed disease, among other manifestations. Because of this complex presentation, the diagnosis and management of patients with ATTR are often challenging and should be performed in interdisciplinary centers specialized in amyloidosis. Here, we aimed to increase awareness of ATTR detection and pathophysiology through a multidimensional multiorgan approach.
We reported on a 60-year-old man with wild-type ATTR who underwent a number of both basic and advanced cardiological and neurological investigations at baseline and after a treatment period with the TTR tetramer stabilizer, tafamidis. Several findings are provided here, some of which might be considered instrumental correlates of the patient's clinical improvement after therapy.
Adequate awareness and prompt recognition of ATTR support early diagnosis and faster access to therapies, thereby slowing the progression and improving the prognosis. The need for a multidisciplinary alliance between specialists and the opportunity to perform, at least in selected cases, a set of specific examinations for a detailed assessment of ATTR patients can also provide valuable insights into the physiopathology and response to therapy of a disease as complex and intriguing as ATTR.
在临床中,转甲状腺素蛋白淀粉样变性(ATTR)的表现存在相当大的异质性,其范围从主要累及心脏和主要累及神经到混合性疾病等其他表现形式。由于这种复杂的表现,ATTR患者的诊断和管理往往具有挑战性,应在专门从事淀粉样变性研究的跨学科中心进行。在此,我们旨在通过多维度多器官方法提高对ATTR检测和病理生理学的认识。
我们报告了一名60岁野生型ATTR男性患者,在基线时以及使用转甲状腺素蛋白四聚体稳定剂tafamidis治疗一段时间后,接受了多项基础和高级心脏及神经学检查。这里提供了一些检查结果,其中一些可能被认为是该患者治疗后临床改善的相关指标。
对ATTR有足够的认识并及时识别有助于早期诊断和更快获得治疗,从而减缓疾病进展并改善预后。专家之间需要多学科联盟,并且至少在某些特定情况下有机会进行一系列特定检查以详细评估ATTR患者,这也能够为像ATTR这样复杂而有趣的疾病的病理生理学和治疗反应提供有价值的见解。