Shin Yongdeok B, McAllister Jenna
Graduate Medical Education (GME) Internal Medicine, Mary Washington Healthcare, Fredericksburg, USA.
Cureus. 2024 Dec 10;16(12):e75443. doi: 10.7759/cureus.75443. eCollection 2024 Dec.
Cardiac amyloidosis is a rare but increasingly recognized cause of heart failure, often underdiagnosed until later stages of the disease. This report describes a case of transthyretin amyloidosis (ATTR) in a 68-year-old male patient with a significant medical history of rheumatoid arthritis (RA), a combination seldom documented in the literature. The patient presented with progressive symptoms of heart failure, and diagnostic testing confirmed ATTR cardiac amyloidosis through pyrophosphate (PYP) scanning. This case highlights the clinical presentation, diagnostic process, and management of cardiac amyloidosis while exploring a potential link between RA and amyloid deposition. Early recognition of cardiac amyloidosis is crucial for improving outcomes, especially in patients with coexisting systemic inflammatory conditions like RA.
心脏淀粉样变性是一种罕见但越来越被认识到的心力衰竭病因,在疾病后期之前常常未被诊断出来。本报告描述了一名68岁男性患者的转甲状腺素蛋白淀粉样变性(ATTR)病例,该患者有类风湿关节炎(RA)的重要病史,这种组合在文献中很少有记载。患者出现进行性心力衰竭症状,诊断性检查通过焦磷酸盐(PYP)扫描确诊为ATTR心脏淀粉样变性。本病例突出了心脏淀粉样变性的临床表现、诊断过程和管理,同时探讨了RA与淀粉样沉积之间的潜在联系。早期识别心脏淀粉样变性对于改善治疗结果至关重要,特别是对于像RA这样存在全身性炎症疾病的患者。