Starry Sky Appearance of an Amyloid Heart in Plasma Cell Dyscrasias

Abstract

We report an extremely rare case of amyloid heart with classical “Starry Sky” appearance in echocardiography in a 52-year-old male presenting with systemic amyloidosis secondary to plasma cell dyscrasias. Interestingly, patient presented with diffuse myalgia unresponsive to traditional nonsteroidal anti-inflammatory drugs with effort dyspnea New York Heart Association Class II secondary to Grade II diastolic dysfunction of stiff myocardium infiltrated with amyloid protein. A starry sky pattern of an amyloid heart led to the retrospective diagnosis of plasma cell dyscrasias with presence of 30% plasma cells in bone marrow biopsy without the presence of M band in serum electrophoresis.

Keywords

• amyloid; plasma cell; protein; sparkling