Diaphragmatic Amyloidosis Causing Respiratory Failure: A Case Report and Review of Literature
نویسندگان
چکیده
Neuromuscular respiratory failure is a rare complication of systemic immunoglobulin light chain amyloidosis. We describe a case of a 70-year-old Caucasian man with multiple myeloma who presented with worsening dyspnea. The patient was diagnosed with and treated for congestive heart failure but continued to suffer from hypercapnic respiratory insufficiency. He had restrictive physiology on pulmonary function tests and abnormal phrenic nerve conduction studies, consistent with neuromuscular respiratory failure. The diagnosis of systemic immunoglobulin light chain amyloidosis was made based on the clinical context and a cardiac biopsy. Despite treatment attempts, the patient passed away in the intensive care unit from hypercapnic respiratory failure. Autopsy revealed dense diaphragmatic amyloid deposits without phrenic nerve infiltration or demyelination or lung parenchymal involvement. Only 5 cases of neuromuscular respiratory failure due to amyloid infiltration of the diaphragm have been described. All cases, including this, were characterized by rapid progression and high mortality. Therefore, diaphragmatic amyloidosis should be on the differential for progressive neuromuscular respiratory failure in patients with multiple myeloma or any other monoclonal gammopathy. Given its poor prognosis, early recognition of this condition is essential in order to address goals of care and encourage pursuit of palliative measures.
منابع مشابه
Anesthetic management of diaphragmatic hernia repair in a dog: a case report and literature review of anesthetic techniques
This case report describes the anesthetic management and ventilation technique in the surgical treatmentof traumatic diaphragmatic hernia in a dog. A 5-month-old 8-kg female terrier with a history of car accidentwas presented for femoral fracture repair. Before anesthetic induction, marked tachypnea and dyspnea werenoted. Diaphragmatic hernia was diagnosed based upon radiographic and ultrasonog...
متن کاملA Rare Presentation of Multiple Myeloma: A Case Report of Hepatic Amyloidosis
The clinically reported case of liver involvement with multiple myeloma (MM) is rare. Amyloidosis, defined as a tissue deposition of clonal light-chain fibrils, has been reported in 10-15% of the MM patients. We described a rare MM patient with the primal presentation of fulminant hepatic failure and biliary system involvement due to amyloidosis. Our patient had the primal symptoms of hyperbili...
متن کاملSilicoproteino-tuberculosis: Three distinct entities or a unique entity: A case report and review of the literature
Silicosis is considered to be among the occupational lung diseases and associated with sandblasting, mining, quarrying and tunneling. Acute silicosis is usually progressive diseaseand despite treatment with corticosteroids it leads to cardio-respiratory failure and death. Alveolar silicoproteinosis is one of it’s acute presentations due to exposure to silica dust and lungs filling with protei...
متن کاملPRIMARY LOCALIZED RETROPERITONEAL AMYLOID TUMOR WITH OSSEOUS META PLASIA: CASE REPORT AND REVIEW OF THE LITERATURE
Amyloidoma or amyloid tumor is a tumor-like localized deposit of amyloid encountered occasionally in association with multiple myeloma, various chronic inflammatory diseases and primary amyloidosis. Amyloid tumors unassociated with plasmacytoma or other disease are extremely rare in soft tissues and few cases in various situations have been reported. Histologic examination discloses amorp...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
دوره 2015 شماره
صفحات -
تاریخ انتشار 2015