A rare clinical case of systemic AA amyloidosis with cardiac involvement complicating ankylosing spondylitis: a case report.
Amyloid goiters
Ankylosing spondylitis
Cardiac amyloidosis
Case report
Secondary amyloidosis
Journal
The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology
ISSN: 2090-911X
Titre abrégé: Egypt Heart J
Pays: Germany
ID NLM: 9106952
Informations de publication
Date de publication:
28 Mar 2024
28 Mar 2024
Historique:
received:
22
11
2023
accepted:
20
03
2024
medline:
28
3
2024
pubmed:
28
3
2024
entrez:
28
3
2024
Statut:
epublish
Résumé
Ankylosing spondylitis (AS) is a type of chronic inflammation that is most prevalent in young adults and is characterized by an inflammatory enthesiopathy that gradually develops toward ossification and ankylosis. If inflammation is left unchecked, it can potentially lead to complications such as secondary amyloidosis, also known as AA amyloidosis, involving the deposition of amyloid serum A protein. Our case presents with a thyroid localization of AA amyloidosis which is secondary to this AS. Such a case has been described in only four cases in the literature. Cardiac localization of AA amyloidosis has been exceptionally described in the literature. We report the case of a young patient with severe AS complicated by secondary amyloidosis with thyroid, cardiac, and probably renal localization. He was treated with anti-TNF therapy, and his condition improved significantly. Our case presents several localizations of AA amyloidosis secondary to this AS. Although cardiac involvement is rare in secondary AA amyloidosis, it should always be screened for, even in a cardiacly asymptomatic patient.
Sections du résumé
BACKGROUND
BACKGROUND
Ankylosing spondylitis (AS) is a type of chronic inflammation that is most prevalent in young adults and is characterized by an inflammatory enthesiopathy that gradually develops toward ossification and ankylosis. If inflammation is left unchecked, it can potentially lead to complications such as secondary amyloidosis, also known as AA amyloidosis, involving the deposition of amyloid serum A protein. Our case presents with a thyroid localization of AA amyloidosis which is secondary to this AS. Such a case has been described in only four cases in the literature. Cardiac localization of AA amyloidosis has been exceptionally described in the literature.
CASE PRESENTATION
METHODS
We report the case of a young patient with severe AS complicated by secondary amyloidosis with thyroid, cardiac, and probably renal localization. He was treated with anti-TNF therapy, and his condition improved significantly.
CONCLUSIONS
CONCLUSIONS
Our case presents several localizations of AA amyloidosis secondary to this AS. Although cardiac involvement is rare in secondary AA amyloidosis, it should always be screened for, even in a cardiacly asymptomatic patient.
Identifiants
pubmed: 38546927
doi: 10.1186/s43044-024-00471-9
pii: 10.1186/s43044-024-00471-9
doi:
Types de publication
Journal Article
Langues
eng
Pagination
40Informations de copyright
© 2024. The Author(s).
Références
Garcia-Montoya L, Gul H, Emery P (2018) Recent advances in ankylosing spondylitis: understanding the disease and management [version 1; referees: 2 approved]. F1000Research , 7:1512. https://doi.org/10.12688/f1000research.14956.1
doi: 10.12688/f1000research.14956.1
Sang Youn Jung, Min-Chan Park, Yong-Beom Park, and Soo-Kon Lee. Serum Amyloid A as a Useful Indicator of Disease Activity in Patients with Ankylosing Spondylitis. Yonsei Med J. 2007 Apr 30; 48(2): 218–224.
Stojanovic KS et al (2017). Amylose AA Néphrol ther. https://doi.org/10.1016/j.nephro.2017.03.001
doi: 10.1016/j.nephro.2017.03.001
pubmed: 28462876
Picken MM (2020) The pathology of amyloidosis in classification: a review. Acta Haematol 143:322–334. https://doi.org/10.1159/000506696
doi: 10.1159/000506696
pubmed: 32392555
Hawkins PN (2002) Serum amyloid P component scintigraphy for diagnosis and monitoring amyloidosis. Curr Opin Nephrol Hypertens 11:649–655
doi: 10.1097/00041552-200211000-00013
pubmed: 12394612
Hazenberg BP, van Rijswijk MH (1994) Clinical and therapeutic aspects of AA amyloidosis, Bailliere’s. Clin Rheumatol 8:661–690
Cohan P, Hirschowitz S, Yu Rao J, Tanavoli S, Van Herle AJ (2000) Amyloid goiter in a case of systemic amyloidosis secondary to ankylosing spondylitis. J Endocrinol Invest 23:762–764
doi: 10.1007/BF03345067
pubmed: 11194711
Amado JA, Palacios S, Manzanos J (1982) Fast growing goitre as the first clinical manifestation of systemic amyloidosis. Postgrad Med J 58:171–172
doi: 10.1136/pgmj.58.677.171
pubmed: 7100042
pmcid: 2426347
Hocaoglu E, Aydemir E, Ates C, Saridas FM, Cander S, Gul OO, et al. A rare case of symptomatic amyloid goiter diagnosed by tru-cut biopsy. Endocrine Abstracts (2022) 81 EP969.
Elaouni, Soukaina, Ahmed J, Fouad Z, Zakia B, Omar E, et al. “Rapid Growing Amyloid Goiter Mimicking a Malignant Thyroid Tumor in 24-Year-Old-Male, Secondary Amyloidosis and End-Stage kidney Failure.” Clin Med Case Rep 5 (2021): 177
Selim Bakan, Sedat Giray Kandemirli, Serkan Akbas, Mehmet Cingoz, Burcu Ozcan Guzelbey, Fatih Kantarci, Canan Akman. Amyloid Goiter: A Diagnosis to Consider in Diffuse Fatty Infiltration of the Thyroid. J Ultrasound Med. 2017 May;36(5):1045–1049. doi: https://doi.org/10.7863/ultra.16.04037 .
Sanchez AC, Murphy R, Rao S, Martinez F, Bryant S, Chaudhuri D (2021) A Case Report of Cardiac Amyloidosis Highlighting the Importance of Strain Analysis. Case Rep Cardiol 12(2021):1–5. https://doi.org/10.1155/2021/5673364
doi: 10.1155/2021/5673364
Obici L, Perfetti V, Palladini G, Moratti R, Merlini G (2005) Clinical aspects of systemic amyloid diseases. Biochem Biophys Acta 1753:11–22
pubmed: 16198646
Li B, Ahluwalia M, Narula N, Moreira AL, Swistel DG, Massera D, Sherrid MV (2020) Cardiac AA Amyloidosis in a Patient with Obstructive Hypertrophic Cardiomyopathy. Cardiovasc Pathol. https://doi.org/10.1016/j.carpath.2020.107218
doi: 10.1016/j.carpath.2020.107218
pubmed: 32949727
Hamer JP, Janssen S, van Rijswijk MH, Lie KI. Amyloid cardiomyopathy in systemic nonhereditary amyloidosis. Clinical, echocardiographic and electrocardiographic findings in 30 patients with AA and 24 patients with AL amyloidosis. Eur Heart J. 1992;13:623–7.
Okuda Y, Yamada T, Ueda M, Ando Y (2018) First Nationwide Survey of 199 Patients with Amyloid A Amyloidosis in Japan. Intern Med 57:3351–3355
doi: 10.2169/internalmedicine.1099-18
pubmed: 30101921
pmcid: 6306533
Kittleson MM, Maurer MS, Ambardekar AV, Bullock-Palmer RP, Chang PP, Eisen HJ, et al. Cardiac Amyloidosis: Evolving Diagnosis and Management: A Scientific Statement From the American Heart Association. Circulation, Volume 142, Issue 1, 7 July 2020; Pages e7-e22. https://www.ahajournals.org/doi/ https://doi.org/10.1161/CIR.0000000000000792
Sharmila Dorbala, MD and al. SNC/AHA/ASE/EANM/HFSA/ISA/SCMR/ SNMMI Expert Consensus Recommendations for Multimodality Imaging in Cardiac Amyloidosis. Part 1 of 2—Evidence Base and Standardized Methods of Imaging. Circ Cardiovasc Imaging. 2021;14:e000029. DOI: https://doi.org/10.1161/HCI.0000000000000029 .
Anatoli Kiotsekoglou MD, PhD and al. Echocardiographic diagnosis of cardiac amyloidosis: Does the masquerader require only a "cherry on top"? Echocardiography. 2020;37:1713–1715. DOI: https://doi.org/10.1111/echo.14952 .
Sanjay M. Banypersad, MRCP, and al. Updates in Cardiac Amyloidosis: A Review. J Am Heart Assoc. 2012;1:e000364 doi: https://doi.org/10.1161/JAHA.111.000364
Westermark GT, Fandrich M, Westermark P (2015) AA Amyloidosis: Pathogenesis and Targeted Therapy. Annu Rev Pathol Mech Dis 10:321–344
doi: 10.1146/annurev-pathol-020712-163913