Iatrogenic Amyloid Polyneuropathy Following Domino Liver Transplantation: A Case Report.

Autor: Junqueira B; Family Health Unit Cartaxo Terra Viva, Regional Health Administration of Lisbon and Tagus Valley, Cartaxo, PRT., Mestre C; Family Health Unit Cartaxo Terra Viva, Regional Health Administration of Lisbon and Tagus Valley, Cartaxo, PRT.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2024 Feb 05; Vol. 16 (2), pp. e53605. Date of Electronic Publication: 2024 Feb 05 (Print Publication: 2024).
DOI: 10.7759/cureus.53605
Abstrakt: Familial amyloidotic polyneuropathy (FAP) is an autosomal dominant hereditary disorder. In Portugal, it is mainly linked to transthyretin (TTR) mutation, and patients present with length-dependent sensory-motor polyneuropathy, often accompanied by autonomic dysfunction. Treatment options for FAP include liver transplant, and due to the lack of organs, FAP livers began being implanted in patients with severe liver disease in a process known as domino liver transplantation (DLT). We report a case of a 68-year-old Portuguese man, with post-hepatitis C-related cirrhosis liver transplantation, who presented to his family doctor with decreased sensitivity in both feet and weight loss, which were initially attributed to diabetic neuropathy and an adjustment in diabetic medication, respectively. Symptoms evolved to changes in both feet's thermal and painful sensitivity, reduced sensitivity in both hands, diarrhea, and progressive weight loss. At this time, the patient's disclosure of receiving a DLT prompted the correct diagnosis of iatrogenic amyloid polyneuropathy. This case underscores the challenges in diagnosing and managing iatrogenic amyloid polyneuropathy following DLT, highlighting the importance of prompt identification of DLT recipients, active vigilance of these patients via structured monitoring, and increased healthcare providers' awareness of this practice so that early signs of the disease may be recognized.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Junqueira et al.)
Databáze: MEDLINE