A Rare Case of Ascites due to Peritoneal Amyloidosis
| Autor: | Luis Otávio Cardoso Mocarzel, Mario G. Ribeiro, Ana Luisa Figueira Gouvêa, Maria Fernanda Barretto, Marcio Ramos Neves, Fernanda Stofer, Ronaldo Altenburg Gismondi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Pathology medicine.medical_specialty Amyloid Peripheral edema 030204 cardiovascular system & hematology Peritoneal Diseases Anasarca 03 medical and health sciences 0302 clinical medicine Rare Diseases Ascites Medicine Humans 030212 general & internal medicine Aged Heart Failure business.industry Amyloidosis Restrictive cardiomyopathy General Medicine Articles medicine.disease Cardiac amyloidosis Heart failure medicine.symptom business |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Male, 65 Final Diagnosis: Peritoneal amyloidosis Symptoms: Anasarca • Dyspnea • Orthopnea Medication: — Clinical Procedure: Paracentesis and peritoneal biopsy Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: The clinical manifestations of amyloidosis depend on the type of insoluble protein as well as the location of amyloid deposits in tissues or organs. In the gastrointestinal tract, the small intestine is the most common site of amyloid deposits, whereas peritoneal involvement and ascites are rare. Case Report: We report on a case of ascites due to peritoneal amyloidosis. A 65-year-old patient was admitted to our institution due to anasarca and pulmonary congestion, mimicking heart failure. We started the patient on diuretics and vasodilators. Despite improvement in pulmonary congestion and peripheral edema, his ascites was not reduced. Echocardiogram revealed restrictive cardiomyopathy and a speckle-tracking pattern suggestive of cardiac amyloidosis. Subcutaneous and peritoneal biopsies revealed amyloidosis. Conclusions: Amyloidosis is rare in the peritoneum and is usually asymptomatic. Ascites occurs in only 20% of patients with peritoneal amyloidosis. We searched PubMed using “ascites” and “amyloidosis” and identified only eight case reports of amyloidosis with ascites. Physicians should be particularly careful in heart failure and anasarca cases when ascites is disproportional or not responsive to diuretic treatment. To date, there is no specific treatment for peritoneal amyloidosis. |
| Databáze: | OpenAIRE |
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