Arterial thromboembolism in senile systemic amyloidosis: report of two cases

Abstract

We describe a rare complication, systemic arterial thromboembolism, seen in two patients with senile systemic amyloidosis (SSA). Case 1 was a 73-year-old man who was tentatively diagnosed as having cardiac amyloidosis. Five months later, he was afflicted by severe left flank pain. CT disclosed renal infarction and then he received endomyocardial biopsy and the transthyretin (TTR) gene analysis, leading to the final diagnosis of SSA. Case 2 was an 88-year-old woman who had been definitively diagnosed as having SSA-related heart failure with atrial fibrillation two years before. She was transferred to the emergency room in our hospital and enhanced CT revealed complete occlusions of the left internal carotid and left vertebral arteries, both subclavian arteries, and the left renal and left internal iliac arteries. Paying much attention to intracardiac thrombosis might be necessary in taking care of SSA patients.

Keywords::

• Amyloidosis
• cardiac amyloidosis
• senile systemic amyloidosis
• transthyretin
• arterial thromboembolism

Declaration of Interest: This study was supported by a grant from the Amyloidosis Research Committee, Ministry of Health, Labour and Welfare, Japan and a Grant-in-Aid for Scientific Research in Japan (20590820 to Shu-ichi Ikeda, 20590695 to Yoshiki Sekijima).