Primary systemic amyloidosis and persistent pleural effusions

Abstract

Persistent pleural effusions are not common in patients with primary systemic amyloidosis (AL). A recent review of this complication of the disease hypothesized that the pathophysiology of these effusions is pleural amyloid deposition, disrupting lymphatic drainage. We report the case of a 73-year-old woman with primary systemic AL and persistent bilateral pleural effusions, refractory to diuresis and repeated thoracenteses. The patient's cardiac and renal dysfunction was not severe enough to explain these persistent effusions. Thus, despite a lack of biopsy-proven amyloid deposition, we suggest that these effusions may be secondary to pleural amyloid deposition.

Keywords:

• Primary systemic amyloidosis
• persistent pleural effusions

Abbreviations
AL	=	primary systemic amyloidosis
CT	=	computed tomography

Abbreviations
AL	=	primary systemic amyloidosis
CT	=	computed tomography

Acknowledgements

The authors wish to thank the patient and her family, and The Alpert School of Medicine at Brown University, for supporting this work. The authors have no disclosures to make.