Сardiopylmonary transthyretin amyloidosis

Abstract

Wild type transthyretin amyloidosis (ATTRwt) affects a number of target organs, most commonly the heart. Over the last years, autopsy findings revealed that the lungs are involved in the pathological process more frequently than diagnosed in premortem cases. Due to the nonspecific nature of ATTRwt clinical manifestations and the presence of multiple concomitant conditions in elderly people, the majority of patients are diagnosed at a late stage or the disease is overlooked. As a result, ATTRwt has emerged as a previously underestimated cause of morbidity and mortality in the older age group. This article presents a clinical case report describing an 88-year-old female patient with generalized transthyretin amyloidosis characterized by predominant cardiac and pulmonary involvement. The paper elucidates the difficulties associated with premortem diagnosis of this type of amyloidosis which include the absence of amyloid deposits in biopsy specimens from the rectum and subcutaneous fat. The specific information in this case report is focused on the discrepancy between clinical and autopsy diagnosis. Keywords: wild type transthyretin amyloidosis, cardiac amyloidosis, pulmonary amyloidosis, senile amy-loidosis, chronic heart failure