NEW-ONSET CARDIAC AMYLOIDOSIS WHILE IN REMISSION FROM SYSTEMIC AL AMYLOIDOSIS

Abiodun Idowu; Lillian Tung; Catherine Chu; Jamario Skeete; Agne Paner; Tochukwu Okwuosa

doi:10.12890/2023_003768

NEW-ONSET CARDIAC AMYLOIDOSIS WHILE IN REMISSION FROM SYSTEMIC AL AMYLOIDOSIS

Eur J Case Rep Intern Med. 2023 Feb 9;10(2):003768. doi: 10.12890/2023_003768. eCollection 2023.

Authors

Abiodun Idowu¹, Lillian Tung², Catherine Chu³, Jamario Skeete⁴, Agne Paner⁵, Tochukwu Okwuosa⁶

Affiliations

¹ Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
² Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
³ Rush University Medical College, Chicago, Illinois, USA.
⁴ Division of Cardiology, Rush University Medical Center, Chicago, Illinois, USA.
⁵ Division of Hematology/Oncology/Cell Therapy, Rush University Medical Center, Chicago, Illinois, USA.
⁶ Division of Cardiology, Section of Cardio-Oncology, Rush University Medical Center, Chicago, Illinois, USA.

Abstract

In light chain amyloidosis, a reduction in dFLC to below 40 mg/l is a prerequisite for organ recovery as nearly half of the patients who achieve very good partial haematological responses have improvement in the function of the involved organ. We describe a patient who developed new-onset cardiac amyloidosis despite a post-treatment reduction in dFLC to <10 mg/l.

Learning points: Patients with light chain (AL) amyloidosis may develop new cardiac involvement despite achieving haematological remission.In patients with AL amyloidosis, a very good partial haematological response (dFLC <10 mg/l) does not obviate the need for regular cardiac monitoring.

Keywords: Light chain; cardiac amyloidosis; plasma cell.