Korean J Med.  2014 Jun;86(6):739-743.

Systemic Amyloid Protein a Amyloidosis Involving the Heart in a Patient with Rheumatoid Arthritis

Affiliations
  • 1Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. eunseok.jeon@samsung.com

Abstract

Amyloidosis can be identified by the deposition of amyloid fibrils in biopsy specimens from multiple organs, including the heart, kidney, skin, and bowel. Systemic amyloid protein A amyloidosis (AA amyloidosis) is commonly associated with chronic inflammatory diseases or chronic infectious conditions. Cardiac involvement in AA amyloidosis is found in < 1% of reported cases. Here, we report a case of cardiac AA amyloidosis confirmed by heart biopsy in a 54-year-old-female with a medical history of rheumatoid arthritis and stage 4 chronic kidney disease due to renal amyloidosis. She had suffered from progressive aggravation of dyspnea for 2 years. Infiltrative disease involving the heart was suspected by echocardiography, and the patient was diagnosed with AA amyloidosis involving the heart by cardiac biopsy. This is a rare case of cardiac involvement in a patient with systemic AA amyloidosis associated with rheumatoid arthritis.

Keyword

Systemic amyloid protein A amyloidosis (AA amyloidosis); Congestive heart failure; Rheumatic arthritis

MeSH Terms

Amyloid*
Amyloidosis*
Arthritis, Rheumatoid*
Biopsy
Dyspnea
Echocardiography
Heart Failure
Heart*
Humans
Kidney
Renal Insufficiency, Chronic
Rheumatic Fever
Skin
Staphylococcal Protein A*
Amyloid
Staphylococcal Protein A
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