Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

16 November 2010

Anasarca and chylous effusions: An unusual presentation of systemic amyloidosis

Maureen R. Horton

Am J Case Rep 2010; 11:191-194 :: ID: 881255

Abstract

Background: Amyloidosis is the result of pathologic deposition of insoluble fibrilar proteins in normal tissues. The resultant accumulation of proteins leads to a wide array of seeming unconnected organ dysfunctions and symptoms often delaying diagnosis.
Case Report: We present a case of primary systemic amyloidosis presenting as anasarca and chylous effusions in a 63 year old man with a past medical history of hypertension and obstructive sleep apnea. The patient noted the onset of anasarca, dyspnea on exertion in the setting of a 50-pound weight loss over 6 months. Through evaluation revealed anasarca, chylous pleural and peritoneal effusions, tachypnea and dyspnea on exertion. Laboratories were unremarkable except for an elevated ESR of 30 and BUN/Cr of 27/1.6 with a bland urinalysis. Chest imaging revealed bilateral pleural effusions with compressive atelectasis and lymphoscintigraphy revealed normal lymphatic flow with no thoracic duct leak. Due to concerns for constrictive pericarditis, the patient underwent a right heart catheterization that was not consistent with pericardial disease. However, endomyocardial biopsy revealed cardiac amyloidosis. Further evaluation revealed elevated free serum Kappa light chains with an elevated free Kappa/Lambda ratio.
Conclusions: We present an atypical presentation of a rare disease, primary AL amyloidosis. Although large pleural effusions are rare in amyloidosis, they are usually exudative and may be due to direct pleural infiltration or amyloid–induced heart, liver, renal or thyroid failure. Thus, large pleural effusions, especially chylous, without clear etiology should raise the suspicion for amyloidosis and lead to further investigations.

Keywords: chylous , anasarca, Amyloidosis

0 Comments

SARS-CoV-2/COVID-19

22 September 2022 : Case report  USA

Rare Case of Persistently Depressed T Lymphocyte Subsets After SARS-CoV-2 Infection

Am J Case Rep In Press; DOI: 10.12659/AJCR.937760  

22 September 2022 : Case report  Poland

Central Retinal Vein Occlusion After Discontinuation of Rivaroxaban Therapy in a Young Patient with COVID-1...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937739  

19 September 2022 : Case report  Spain

Inhaled Nitric Oxide in Acute Severe Pulmonary Hypertension and Severe Acute Respiratory Distress Syndrome ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937147  

14 September 2022 : Case report  Japan

Case Report: A 29-Year-Old Pregnant Woman at 24 Weeks of Gestation Presenting with Laryngotracheitis and CO...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937834  

In Press

27 Sep 2022 : Case report  Slovenia

Compound Heterozygote Mutation in the SMPD1 Gene Leading to Nieman-Pick Disease Type A

Am J Case Rep In Press; DOI: 10.12659/AJCR.937220  

26 Sep 2022 : Case report  Saudi Arabia

An Infant Presenting with Interstitial Lung Disease Diagnosed Later as Hunter Syndrome: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.937527  

26 Sep 2022 : Case report  Thailand

Acute Intermittent Porphyria: Complete Phenotype in a Patient with p.Arg173Trp Variant in Thailand

Am J Case Rep In Press; DOI: 10.12659/AJCR.937695  

26 Sep 2022 : Case report  USA

Injury to the Posterior Horn of the Lateral Meniscus from a Misplaced Tibial Tunnel for Anterior Cruciate L...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937581  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923