Systemic amyloidosis: A big masquerade of clinical symptoms with catastrophic consequences

A. Amusat, O. Adebisi, O. Kayode, S. Adebayo, T. Olunuga, O. Oke, O. Owoseni, F. Arogundade
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Abstract

A case of a 52-year-old woman presented with non-specific symptoms: generalised weakness, loss of appetite and left leg pain of about a week duration. She later developed nephrotic syndrome, cardiomegaly with arrhythmias, adrenal insufficiency, cutaneous amyloid, with consolidation on chest X-ray and hepatomegaly. She had a renal biopsy that revealed renal amyloidosis. She was treated with thalidomide, bortezomib, methylprednisolone, ranitidine and allopurinol without significant improvement. Amyloidosis is a rare disease that requires a high index of suspicion. She may have responded if she had been diagnosed early, and hence, early diagnosis is a key in successful management.
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全身性淀粉样变性:临床症状的大伪装,后果灾难性
一例52岁妇女,出现非特异性症状:全身无力、食欲不振和左腿疼痛,持续约一周。她后来发展为肾病综合征,心脏肿大并心律失常,肾上腺功能不全,皮肤淀粉样蛋白,胸片实变和肝肿大。她的肾脏活检显示肾脏淀粉样变。她接受沙利度胺、硼替佐米、甲基强的松龙、雷尼替丁和别嘌呤醇治疗,无明显改善。淀粉样变是一种罕见的疾病,需要高度怀疑。如果早期诊断,她可能会有反应,因此,早期诊断是成功治疗的关键。
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