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Two types of amyloidosis presenting in a single patient: a case series
The amyloidoses are a group of disorders with overlapping clinical presentations, characterized by aggregation and tissue deposition of misfolded proteins. The nature and source of the amyloidogenic protein determines therapy, therefore correct subtyping is critical to patient management. We report...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6401104/ https://www.ncbi.nlm.nih.gov/pubmed/30837451 http://dx.doi.org/10.1038/s41408-019-0193-9 |
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author | Sidiqi, M. Hasib McPhail, Ellen D. Theis, Jason D. Dasari, Surendra Vrana, Julie A. Drosou, Maria Eleni Leung, Nelson Hayman, Suzanne Rajkumar, S. Vincent Warsame, Rahma Ansell, Stephen M. Gertz, Morie A. Grogan, Martha Dispenzieri, Angela |
author_facet | Sidiqi, M. Hasib McPhail, Ellen D. Theis, Jason D. Dasari, Surendra Vrana, Julie A. Drosou, Maria Eleni Leung, Nelson Hayman, Suzanne Rajkumar, S. Vincent Warsame, Rahma Ansell, Stephen M. Gertz, Morie A. Grogan, Martha Dispenzieri, Angela |
author_sort | Sidiqi, M. Hasib |
collection | PubMed |
description | The amyloidoses are a group of disorders with overlapping clinical presentations, characterized by aggregation and tissue deposition of misfolded proteins. The nature and source of the amyloidogenic protein determines therapy, therefore correct subtyping is critical to patient management. We report the clinicopathologic features of nine patients diagnosed with two amyloid types confirmed by liquid chromatography-coupled tandem mass spectrometry. The most common types were transthyrethin (n = 9) and immunoglobulin-derived (n = 7). Two patients did not have immunoglobulin-derived amyloidosis despite the presence of a monoclonal gammopathy. Eight patients were diagnosed with two types concurrently, and one patient had an 11-year interval between diagnoses. Histopathological distribution of amyloid was variable with vascular, interstitial, and periosteal deposits seen. Identification of a second type was incidental in seven patients, but led to genetic counselling in one patient and therapy directed at both amyloid subtypes in another. With longer survival of myeloma and AL amyloidosis patients and increasing prevalence of patients with wild-type transthyretin amyloidosis due to an aging population, the phenomenon of two amyloid types in a single patient will be encountered more frequently. In light of revolutionary new therapies for transthyretin amyloidosis (patisiran, tafamidis, and inotersen), recognition of dual amyloid types is highly clinically relevant. |
format | Online Article Text |
id | pubmed-6401104 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-64011042019-03-06 Two types of amyloidosis presenting in a single patient: a case series Sidiqi, M. Hasib McPhail, Ellen D. Theis, Jason D. Dasari, Surendra Vrana, Julie A. Drosou, Maria Eleni Leung, Nelson Hayman, Suzanne Rajkumar, S. Vincent Warsame, Rahma Ansell, Stephen M. Gertz, Morie A. Grogan, Martha Dispenzieri, Angela Blood Cancer J Article The amyloidoses are a group of disorders with overlapping clinical presentations, characterized by aggregation and tissue deposition of misfolded proteins. The nature and source of the amyloidogenic protein determines therapy, therefore correct subtyping is critical to patient management. We report the clinicopathologic features of nine patients diagnosed with two amyloid types confirmed by liquid chromatography-coupled tandem mass spectrometry. The most common types were transthyrethin (n = 9) and immunoglobulin-derived (n = 7). Two patients did not have immunoglobulin-derived amyloidosis despite the presence of a monoclonal gammopathy. Eight patients were diagnosed with two types concurrently, and one patient had an 11-year interval between diagnoses. Histopathological distribution of amyloid was variable with vascular, interstitial, and periosteal deposits seen. Identification of a second type was incidental in seven patients, but led to genetic counselling in one patient and therapy directed at both amyloid subtypes in another. With longer survival of myeloma and AL amyloidosis patients and increasing prevalence of patients with wild-type transthyretin amyloidosis due to an aging population, the phenomenon of two amyloid types in a single patient will be encountered more frequently. In light of revolutionary new therapies for transthyretin amyloidosis (patisiran, tafamidis, and inotersen), recognition of dual amyloid types is highly clinically relevant. Nature Publishing Group UK 2019-03-05 /pmc/articles/PMC6401104/ /pubmed/30837451 http://dx.doi.org/10.1038/s41408-019-0193-9 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Sidiqi, M. Hasib McPhail, Ellen D. Theis, Jason D. Dasari, Surendra Vrana, Julie A. Drosou, Maria Eleni Leung, Nelson Hayman, Suzanne Rajkumar, S. Vincent Warsame, Rahma Ansell, Stephen M. Gertz, Morie A. Grogan, Martha Dispenzieri, Angela Two types of amyloidosis presenting in a single patient: a case series |
title | Two types of amyloidosis presenting in a single patient: a case series |
title_full | Two types of amyloidosis presenting in a single patient: a case series |
title_fullStr | Two types of amyloidosis presenting in a single patient: a case series |
title_full_unstemmed | Two types of amyloidosis presenting in a single patient: a case series |
title_short | Two types of amyloidosis presenting in a single patient: a case series |
title_sort | two types of amyloidosis presenting in a single patient: a case series |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6401104/ https://www.ncbi.nlm.nih.gov/pubmed/30837451 http://dx.doi.org/10.1038/s41408-019-0193-9 |
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