ABSTRACT
Resumen La sarcoidosis es una enfermedad granulomatosa crónica relacionada frecuentemente con antígenos ambientales e infecciones. Sin embargo, no se ha logrado identificar una causa clara en todos los escenarios. Por su parte, la amiloidosis secundaria se caracteriza por el depósito de proteína amiloide AA en los diferentes tejidos, la cual se asocia a procesos inflamatorios crónicos. Es supremamente infrecuente coincidir con estas dos enfermedades ya que no existe una relación de causalidad directa. A continuación presentamos un caso de un paciente con hallazgos de esta rara asociación.
Abstract Sarcoidosis is a chronic granulomatous disease, frequently attributed to environmental antigens (organic and inorganic) and infections. However, it is quite common not to find a clear cause behind this pathology. Alternatively, secondary amyloidosis is characterized my Amyloid AA protein deposition in different tissues, which is associated with chronic inflammation. Nonetheless, it is extremely uncommon to find both sarcoidosis and secondary AA amyloidosis simultaneously provided that there is no a clear causality relationship between both. We present an interesting case of a patient with this uncommon duality.
ABSTRACT
Amyloidosis can be identified by the deposition of amyloid fibrils in biopsy specimens from multiple organs, including the heart, kidney, skin, and bowel. Systemic amyloid protein A amyloidosis (AA amyloidosis) is commonly associated with chronic inflammatory diseases or chronic infectious conditions. Cardiac involvement in AA amyloidosis is found in < 1% of reported cases. Here, we report a case of cardiac AA amyloidosis confirmed by heart biopsy in a 54-year-old-female with a medical history of rheumatoid arthritis and stage 4 chronic kidney disease due to renal amyloidosis. She had suffered from progressive aggravation of dyspnea for 2 years. Infiltrative disease involving the heart was suspected by echocardiography, and the patient was diagnosed with AA amyloidosis involving the heart by cardiac biopsy. This is a rare case of cardiac involvement in a patient with systemic AA amyloidosis associated with rheumatoid arthritis.