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Systemic amyloidosis with predominant cardiac involvement associated with multiple myeloma

https://doi.org/10.21886/2219-8075-2025-16-3-75-82

Abstract

A clinical case of amyloid cardiomyopathy associated with multiple myeloma with the development of chronic heart failure with preserved ejection fraction refractory to therapy is presented. The role of clinical signs, especially “red flags” of amyloidosis, is studied, as well as the need to increase physicians’ awareness of the symptoms and signs of amyloid cardiomyopathy, and early detection and treatment of the pathology. Current diagnostic methods are discussed, including histological examination and immunophenotyping, which can improve the patient’s prognosis.

About the Authors

M. K. Akhverdieva
Rostov State Medical University
Russian Federation

Milana K. Akhverdieva, Cand. Sci. (Med.), Associate Professor of the Department of Therapy

Rostov-on-Don


Competing Interests:

Authors declares no conflict of interest



I. A. Garina
Rostov State Medical University
Russian Federation

Irina A. Garina, Cand. Sci. (Med.), Assistant at the Department of Therapy

Rostov-on-Don


Competing Interests:

Authors declares no conflict of interest



V. V. Zhivaga
Rostov State Medical University
Russian Federation

Valeria V. Zhivaga, Clinical Resident of the Department of Therapy with the Course of Outpatient Therapy

Rostov-on-Don


Competing Interests:

Authors declares no conflict of interest



M. S. Litvinova
Rostov State Medical University
Russian Federation

Marina S. Litvinova, Cand. Sci. (Med.),Assistant at the Department of Therapy

Rostov-on-Don


Competing Interests:

Authors declares no conflict of interest



L. A. Khaisheva
Rostov State Medical University
Russian Federation

Larisa A. Khaisheva, Dr. Sci. (Med.), Professor at the Department of Therapy

Rostov-on-Don


Competing Interests:

Authors declares no conflict of interest



References

1. Zagrebneva A.I., Poteshkina N.G., Kuznechenko D.I., Babak V.V. Systemic amyloidosis associated with multiple myeloma: clinical observation. RMJ. 2018;12(II):107–109. (In Russ.) eLIBRARY ID: 36578898 EDN: VOIHOV

2. Orlov F.I., Ansheles A.A., Nasonova S.N., Saidova M.A., Zhirov I.V., et al. Difficulties in differential diagnosis of the AL- and ATTR-cardiac amyloidosis. Case report. Terapevticheskii arkhiv. 2023;95(9):789-795. (In Russ.) https://doi.org/10.26442/00403660.2023.09.202376

3. Gudkova A.Y., Lapekin S.V., Bezhanishvili T.G., Trukshina M.A., Davydova V.G., et al. AL-amyloidosis with cardiac involvement. Diagnostic capabilities of non-invasive methods. Terapevticheskii arkhiv. 2021;93(4):487-496. https://doi.org/10.26442/00403660.2021.04.200689

4. Moiseev S.V., Rameev V.V. Tafamidis in the treatment of transthyretin cardiac amyloidosis. Clinical Pharmacology and Therapeutics. 2021;30(2):44-50. (In Russ.). https://doi.org/10.32756/0869-5490-2021-2-44-50

5. Tereshchenko S.N., Nasonova S.N., Zhirov I.V., Saidova M.A., Ansheles A.A., et al. Amyloidosis of the heart. Moscow: Federal State Budgetary Institution “National Medical Research Center of Cardiology” of the Ministry of Health of the Russian Federation; 2021. (In Russ.) eLIBRARY ID: 46699146 EDN: DMWKPZ

6. Garcia-Pavia P, Bengel F, Brito D, Damy T, Duca F, et al. Expert consensus on the monitoring of transthyretin amyloid cardiomyopathy. Eur J Heart Fail. 2021;23(6):895-905. https://doi.org/10.1002/ejhf.2198

7. Anikonova L.I., Vorobyeva O.A., Bakulina N.V. ATTR-amyloidosis - a systemic disease involving the kidneys. Nephrology and Dialysis. 2022;24(3):441-456. (In Russ.) https://doi.org/10.28996/2618-9801-2022-3-441-456

8. Reznik E.V., Nguyen T.L., Borisovskaya S.V., Brylev L.V., Zhelnin A.V., Seksyaev N.E. A Clinical Case of the Hereditary Transthyretin Amyloidosis. The Russian Archives of Internal Medicine. 2021;11(3):229-240. https://doi.org/10.20514/2226-6704-2021-11-3-229-240

9. Adyan T.A., Polyakov A.V. Hereditary transthyretin amyloidosis. Neuromuscular Diseases. 2019;9(4):12-25. (In Russ.) https://doi.org/10.17650/2222-8721-2019-9-4-12-25

10. Reznik E.V., Nguyen T.L., Stepanova E.A., Ustyuzhanin D.V., Nikitin I.G. Cardiac Amyloidosis: Internist and Cardiologist Insight. The Russian Archives of Internal Medicine. 2020;10(6):430-457. https://doi.org/10.20514/2226-6704-2020-10-6-430-457

11. Rowczenio D, Quarta CC, Fontana M, Whelan CJ, Martinez-Naharro A, et al. Analysis of the TTR gene in the investigation of amyloidosis: A 25-year single UK center experience. Hum Mutat. 2019;40(1):90-96. https://doi.org/10.1002/humu.23669

12. Yilmaz A, Bauersachs J, Bengel F, Büchel R, Kindermann I, et al. Diagnosis and treatment of cardiac amyloidosis: position statement of the German Cardiac Society (DGK). Clin Res Cardiol. 2021;110(4):479-506. https://doi.org/10.1007/s00392-020-01799-3

13. Lysenko (Kozlovskaya) L.V., Rameev V.V., Moiseev S.V., Blagova O.V., Bogdanov E.I., et al. Clinical guidelines for diagnosis and treatment of systemic amyloidosis. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Therapy. 2020;29(1):13-24. (In Russ.). https://doi.org/10.32756/0869-5490-2020-1-13-24

14. Maurer MS, Schwartz JH, Gundapaneni B, Elliott PM, Merlini G, et al. Tafamidis Treatment for Patients with Transthyretin Amyloid Cardiomyopathy. N Engl J Med. 2018;379(11):1007-1016. https://doi.org/10.1056/NEJMoa1805689

15. Pankuweit S, Dörr R. Erratum zu: Diagnose und Behandlung der kardialen Amyloidose : Positionspapier der ESC Working Group on Myocardial and Pericardial Diseases 2021 [Erratum to: Diagnosis and treatment of cardiac amyloidosis : A position statement of the ESC Working Group on Myocardial and Pericardial Diseases 2021]. Herz. 2022;47(2):176. (In German). Erratum for: Herz. 2022;47(1):41-47. https://doi.org/10.1007/s00059-022-05100-2

16. Ishaq S, Lin F, Martins J, Huggett R. Unexpected manifestation of cardiac amyloidosis. BMJ Case Rep. 2018;2018:bcr2017222852. https://doi.org/10.1136/bcr-2017-222852

17. Ash S, Shorer E, Ramgobin D, Vo M, Gibbons J, et al. Cardiac amyloidosis-A review of current literature for the practicing physician. Clin Cardiol. 2021;44(3):322-331. https://doi.org/10.1002/clc.23572

18. Lu Y, Jiang Y, Prokaeva T, Connors LH, Costello CE. Oxidative Post-Translational Modifications of an Amyloidogenic Immunoglobulin Light Chain Protein. Int J Mass Spectrom. 2017;416:71-79. https://doi.org/10.1016/j.ijms.2016.11.006

19. Kocher F, Kaser A, Escher F, Doerler J, Zaruba MM, et al. Heart failure from ATTRwt amyloid cardiomyopathy is associated with poor prognosis. ESC Heart Fail. 2020;7(6):3919-3928. https://doi.org/10.1002/ehf2.12986

20. Muchtar E, Gertz MA, Kumar SK, Lacy MQ, Dingli D, et al. Improved outcomes for newly diagnosed AL amyloidosis between 2000 and 2014: cracking the glass ceiling of early death. Blood. 2017;129(15):2111-2119. https://doi.org/10.1182/blood-2016-11-751628

21. Fradley MG, Thakuria JV, Collins AB, Moore SA, Stone JR. Direct tissue evaluation via immunofluorescence: in the diagnosis of hereditary transthyretin cardiac amyloidosis. Tex Heart Inst J. 2012;39(1):71-75. PMID: 22412233; PMCID: PMC3298917.

22. Kristen AV. Amyloid cardiomyopathy. Herz. 2020;45(3): 267-271. https://doi.org/10.1007/s00059-020-04904-4

23. Quarta CC, Gonzalez-Lopez E, Gilbertson JA, Botcher N, Rowczenio D, et al. Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis. Eur Heart J. 2017;38(24):1905-1908. https://doi.org/10.1093/eurheartj/ehx047.


Review

For citations:


Akhverdieva M.K., Garina I.A., Zhivaga V.V., Litvinova M.S., Khaisheva L.A. Systemic amyloidosis with predominant cardiac involvement associated with multiple myeloma. Medical Herald of the South of Russia. 2025;16(3):75-82. (In Russ.) https://doi.org/10.21886/2219-8075-2025-16-3-75-82

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