99mTc-HMDP scintigraphy rectifies wrong diagnosis of AL amyloidosis

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• 作者：Arnault Galat MD ; Axel Van Der Gucht MD…
• 关键词：99mTc ; HMDP scintigraphy ; cardiac amyloidosis ; transthyretin ; protein deposition ; light ; chain immunoglobulin
• 刊名：Journal of Nuclear Cardiology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：22
• 期：4
• 页码：853-857
• 全文大小：1,011 KB
• 参考文献：1.Glaudemans AWJM, van Rheenen RWJ, van den Berg MP, Noordzij W, Koole M, Blokzijl H, et al. Bone scintigraphy with (99m)technetium-hydroxymethylene diphosphonate allows early diagnosis of cardiac involvement in patients with transthyretin-derived systemic amyloidosis. Amyloid 2014;21:35-44.View Article PubMed
  2.Eriksson P, Backman C, Bjerle P, Eriksson A, Holm S, Olofsson BO. Non-invasive assessment of the presence and severity of cardiac amyloidosis. A study in familial amyloidosis with polyneuropathy by cross sectional echocardiography and technetium-99m pyrophosphate scintigraphy. Br Heart J 1984;52:321-6.PubMed Central View Article PubMed
  3.Worsley DF, Lentle BC. Uptake of technetium-99m MDP in primary amyloidosis with a review of the mechanisms of soft tissue localization of bone seeking radiopharmaceuticals. J Nucl Med 1993;34:1612-5.PubMed
  4.Kulhanek J, Movahed A. Uptake of technetium 99m HDP in cardiac amyloidosis. Int J Cardiovasc Imaging 2003;19:225-7.View Article PubMed
  5.Rapezzi C, Quarta CC, Guidalotti PL, Pettinato C, Fanti S, Leone O, et al. Role of (99m)Tc-DPD scintigraphy in diagnosis and prognosis of hereditary transthyretin-related cardiac amyloidosis. JACC Cardiovasc Imaging 2011;4:659-70.View Article PubMed
  6.Lee VW, Caldarone AG, Falk RH, Rubinow A, Cohen AS. Amyloidosis of heart and liver: Comparison of Tc-99m pyrophosphate and Tc-99m methylene diphosphonate for detection. Radiology 1983;148:239-42.View Article PubMed
  7.De Haro-del Moral FJ, S谩nchez-Lajusticia A, G贸mez-Bueno M, Garc铆a-Pav铆a P, Salas-Ant贸n C, Segovia-Cubero J. Role of cardiac scintigraphy with 99mTc-DPD in the differentiation of cardiac amyloidosis subtype. Rev Esp Cardiol 2012;65:440-6.View Article PubMed
  
• 作者单位：Arnault Galat MD (1) (2) (3) (4) (5)
  Axel Van Der Gucht MD (1) (2) (5) (6)
  Magali Colombat MD, PhD (10) (9)
  David Attias MD (11)
  Emmanuel Itti MD, PhD (1) (2) (5) (6)
  Michel Meignan MD, PhD (1) (2) (5) (6)
  Fabien Lebras MD (1) (2) (5) (7)
  Val茅rie Molinier-Frenkel MD, PhD (1) (12) (2) (4)
  Nicole Benhaiem MD (1) (2) (5) (8)
  Aziz Guellich PhD (1) (2) (3) (4) (5)
  Jean Rosso MD (1) (2) (5) (6)
  Thibaud Damy MD, PhD (1) (2) (3) (4) (5)
  
  1. UPEC, 94000, Cr茅teil, France
  2. Mondor Amyloidosis Network, 94000, Cr茅teil, France
  3. Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94010, Cr茅teil, France
  4. INSERM U955, 94000, Cr茅teil, France
  5. DHU ATVB, 94000, Cr茅teil, France
  6. Department of Nuclear Medicine, AP-HP, Henri-Mondor Teaching Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94010, Cr茅teil, France
  10. Paris Descartes University Proteomics Platform, 75014, Paris, France
  9. Department of Pathology, Foch Hospital, 92151, Suresnes, France
  11. Department of Cardiology, Centre Cardiologique du Nord, 32 rue des Moulins G茅meaux, 93200, Saint-Denis, France
  7. Department of Hematology, AP-HP, Henri-Mondor Teaching Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94010, Cr茅teil, France
  12. Department of Clinical Immunology, AP-HP, Henri-Mondor Teaching Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94010, Cr茅teil, France
  8. Department of Pathology, AP-HP, Henri-Mondor Teaching Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94010, Cr茅teil, France
  
• 刊物主题：Cardiology; Nuclear Medicine; Imaging / Radiology;
• 出版者：Springer US
• ISSN：1532-6551

文摘

A 71-year-old African man without history of cardiac disease was referred to our center for dyspnea. Transthoracic echocardiogram and cardiac MRI were suggestive of cardiac amyloidosis (CA). The diagnosis of the light-chain cardiac amyloidosis (AL-CA) was made after a first endomyocardial biopsy. Accordingly chemotherapy was started. Systematic 99mTc-HMDP scintigraphy showed moderate cardiac uptake (visual score of 2), unusual for AL-CA, and permitted to rectify the diagnosis. Hereditary transthyretin cardiac amyloidosis was confirmed by a second endomyocardial biopsy with a positive Congo-red and anti-transthyretin antibody stainings, mass spectrometry and genetic analysis (Val122Ile mutation).