Primary Systemic Amyloidosis: A Case Report

JNMA J Nepal Med Assoc. 2023 Oct 1;61(266):822-824. doi: 10.31729/jnma.8297.

Abstract

Primary systemic amyloidosis is a systemic disease characterised by the deposition of misfolded proteins extracellularly in different organs without any known cause in the background, eventually leading to multiorgan dysfunction and death. The incidence of primary amyloidosis is estimated at 5.1-12.8 cases per million, with a poor prognosis. We report a case of a 69-year male with lower back pain, shortness of breath, and anasarca diagnosed as primary systemic amyloidosis by serum-free light chain assay and kidney needle biopsy. He was started on intravenous bortezomib and dexamethasone. Though he adhered to his medications, with time he developed renal insufficiency marked by azotemia following which hemodialysis was performed. Primary systemic amyloidosis is a rare clinical condition with a very poor prognosis. Further studies are needed to understand the proper pathophysiology and treatment of the disease.

Keywords: cardiomyopathies; case reports; primary amyloidosis.

Publication types

  • Case Reports

MeSH terms

  • Amyloidosis* / diagnosis
  • Amyloidosis* / drug therapy
  • Amyloidosis* / pathology
  • Bortezomib / therapeutic use
  • Humans
  • Immunoglobulin Light-chain Amyloidosis* / complications
  • Immunoglobulin Light-chain Amyloidosis* / diagnosis
  • Immunoglobulin Light-chain Amyloidosis* / drug therapy
  • Male
  • Prognosis
  • Renal Insufficiency*

Substances

  • Bortezomib