Biopsy Evidence of Sequential Transthyretin and Immunoglobulin Light-Chain Cardiac Amyloidosis in the Same Patient

Giuseppe Vergaro, MD, PhD; Vincenzo Castiglione, MD; Roberta Poletti, MD; Gabriele Buda, MD; Angela Pucci, MD, PhD; Veronica Musetti, BSc; Dario Genovesi, MD; Alberto Aimo, MD; Claudio Passino, MD; Michele Emdin, MD, PhD

JACC: Case Reports (Mar 2021)

Biopsy Evidence of Sequential Transthyretin and Immunoglobulin Light-Chain Cardiac Amyloidosis in the Same Patient

Giuseppe Vergaro, MD, PhD,
Vincenzo Castiglione, MD,
Roberta Poletti, MD,
Gabriele Buda, MD,
Angela Pucci, MD, PhD,
Veronica Musetti, BSc,
Dario Genovesi, MD,
Alberto Aimo, MD,
Claudio Passino, MD,
Michele Emdin, MD, PhD

Affiliations

Giuseppe Vergaro, MD, PhD: Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Address for correspondence: Dr. Giuseppe Vergaro, Scuola Superiore Sant’Anna and Fondazione Toscana Gabriele Monasterio, Via G. Moruzzi 1, 56124 Pisa, Italy.
Vincenzo Castiglione, MD: Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
Roberta Poletti, MD: Fondazione Toscana Gabriele Monasterio, Pisa, Italy
Gabriele Buda, MD: Hematology Department, University of Pisa, Pisa, Italy
Angela Pucci, MD, PhD: Histopathology Department, University of Pisa, Pisa, Italy
Veronica Musetti, BSc: Fondazione Toscana Gabriele Monasterio, Pisa, Italy
Dario Genovesi, MD: Fondazione Toscana Gabriele Monasterio, Pisa, Italy
Alberto Aimo, MD: Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
Claudio Passino, MD: Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy
Michele Emdin, MD, PhD: Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy

Journal volume & issue: Vol. 3, no. 3
pp. 450 – 454

Abstract

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Currently adopted diagnostic flow charts consider transthyretin and light-chain cardiac amyloidosis as mutually exclusive. Here, we report for the first time, to our knowledge, the demonstration of a biopsy-proven dual pathology in an 80-year-old man with sequential development of both wild-type transthyretin amyloidosis and light-chain cardiac amyloidosis cardiomyopathy over a 3-year timespan. (Level of Difficulty: Intermediate.)

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

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