Chest
Introducing New Members of the Editorial Board Clinical InvestigationAmyloidosis and Pleural Disease
Section snippets
Case 1
A 71-year-old woman presented in April 1987 for evaluation of a two-year history of progressive dyspnea on exertion and right pleural effusion. She had a two-year history of seronegative rheumatoid arthritis and Sjögren's syndrome. In August 1986 she underwent a small bowel biopsy for evaluation of chronic diarrhea and was diagnosed as having amyloidosis of the bowel. A thoracentesis was performed and the fluid characteristics are summarized in Table 2. A Cope needle biopsy of the pleura was
Discussion
Pleural effusions appear to occur not infrequently in patients with systemic amyloidosis, 30 percent in one series.10 The cause for the pleural effusions is most often congestive heart failure. Indeed, a large review of 333 patients with systemic amyloidosis from 13 studies revealed that the incidence of histologic involvement of the heart was 66 percent, with 46 percent incidence of clinically evident congestive heart failure, with or without pleural efiusions.10 Other data suggest that there
References (19)
- et al.
Type and distribution of pulmonary parenchymal and vascular amyloid: correlation with cardiac amyloid
Am J Med
(1979) - et al.
Patterns of pulmonary involvement in systemic amyloidosis
Chest
(1978) - et al.
Clinical aspects of pulmonary amyloidosis
Chest
(1987) - et al.
Clinically significant cardiac amyloidosis: clinico-pathologic findings in 15 patients
Am J Cardiol
(1970) - et al.
Amyloidosis of the lower respiratory tract
Chest
(1986) - et al.
Points to consider when choosing a biopsy method in cases of pleurisy of unknown origin
Chest
(1983) The lung in generalized amyloidosis
Acta Pathol Jpn
(1972)- et al.
Amyloidosis: review of 236 cases
Medicine
(1975) Amyloidosis
N Engl J Med
(1967)
Cited by (44)
Pulmonary manifestations of amyloidosis
2023, Respiratory MedicineThe spectrum of pulmonary amyloidosis
2023, Respiratory MedicinePrimary systemic amyloidosis: A rare cause for pleural effusion
2014, Respiratory Medicine Case ReportsCitation Excerpt :Pleural effusions in patients with amyloidosis which is a rare cause for massive effusion can cause dyspnoea and may require repeated thoracentesis to relieve symptoms as was the situation in our case which finally required intercostal tube drainage for dyspnoea management. One of the first reports of amyloid-associated pleural effusion included five patients by Kavuru et al. [10]. These authors found that pleural effusions in the majority of their patients (60% in their series) were believed to be related to either congestive heart disease or nephrotic syndrome, and only 40% of pleural effusions were “idiopathic”.
A 71-year-old woman with an unusual cause for pleural effusions
2011, ChestCitation Excerpt :Furthermore, Berk et al7 found that aggressive diuretic therapy was unsuccessful at resolving persistent AL amyloidosis effusions, which is likely due to an impaired ability of the lymphatic system to reabsorb excess fluid. Multiple case reports have described a plethora of amyloid nodules measuring up to 5 mm in diameter on patients' parietal pleura.9–12 The mechanical occlusion of the parietal stomata is thought to be the cause for the persistence of pleural effusions in AL amyloidosis.
Pulmonary amyloidosis and non-amyloid immunoglobulin deposits
2008, Revue des Maladies Respiratoires
Manuscript received August 24; revision accepted November 10.