Document Detail


AL cardiac amyloidosis and arterial thromboembolic events.
MedLine Citation:
PMID:  16195166     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the prevalence and characteristics of arterial thromboembolic events (ATEE) in the course of AL amyloidosis. METHODS: We report the case of a non-anticoagulated patient with AL amyloidosis restrictive cardiomyopathy who developed acute lower limb ischaemia. We then prospectively determined the prevalence of ATEE in all patients with AL amyloidosis who were evaluated in our institution for autologous peripheral stem cell transplantation. RESULTS: Nine out of 15 non-anticoagulated patients (60%) developed ATEE: ischaemic stroke (3), transient cerebral ischaemic attack (2), multiple peripheral arterial emboli (1), bilateral iliac artery thrombosis (1), bilateral optic nerve ischaemia (1), and mesenteric ischaemia (1). Haemodynamic stasis seemed to play a leading role in the pathophysiology of ATEE, in that all patients were on sinus rhythm and only one had a thrombus on echocardiography. We identified possible contributing factors to ATEE occurrence: concomitant treatments with oestroprogestogen regimen, thalidomide, granulocyte-macrophage colony-stimulating factor (GM-CSF) and extracellular volume disturbances related to the cytapheresis procedure. CONCLUSION: We report on an unusual frequency of ATEE among patients with AL cardiac amyloidosis. Despite its theoretical risks, anticoagulation should be discussed for patients with amyloid cardiomyopathy.
Authors:
P Hausfater; N Costedoat-Chalumeau; Z Amoura; P Cacoub; T Papo; G Grateau; V Leblond; P Godeau; J C Piette
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Scandinavian journal of rheumatology     Volume:  34     ISSN:  0300-9742     ISO Abbreviation:  Scand. J. Rheumatol.     Publication Date:    2005 Jul-Aug
Date Detail:
Created Date:  2005-09-30     Completed Date:  2005-11-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0321213     Medline TA:  Scand J Rheumatol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  315-9     Citation Subset:  IM    
Affiliation:
Emergency Department, Pitie-Salpetriere University Hospital Centre, 75651 Paris Cedex 13, France. pierre.hausfater@psl.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Amyloidosis / complications,  diagnosis*,  therapy
Angiography / methods
Arterial Occlusive Diseases / complications,  radiography,  surgery*
Cardiomyopathies / complications,  diagnosis*,  therapy
Disease Progression
Embolectomy / methods
Fatal Outcome
Female
Femoral Artery*
Heart Failure / diagnosis*
Humans
Risk Assessment

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