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Background: A 63-year-old Black woman presented with progressive exertional dyspnea and chronic lower back pain. The course and findings in her case are instructive.

Case Report: Family history was notable for cardiac deaths.

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Objective: This study aims to delineate the clinical profiles of the hereditary transthyretin amyloid polyneuropathy (ATTRv-PN) patients with A97S variant from southern China and the molecular characteristics of this mutant protein.

Methods: Fifteen ATTRv-PN patients with heterozygous A97S and one patient with homozygous A97S were included in the study. Serum TTR tetramer concentration was quantified through ultra-performance liquid chromatography.

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Coexistence of variant-type transthyretin and immunoglobulin light-chain amyloidosis: a case report.

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June 2024

Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa 252-0374, Japan.

Background: Determining the type of amyloid deposits is clinically important for choosing the specific therapies for cardiac amyloidosis.

Case Summary: A 78-year-old woman who had been experiencing fluid retention and dyspnoea on exertion for 6 months was referred to our hospital for the management of heart failure with left ventricular hypertrophy. Since Tc-hydroxymethylene diphosphonate scintigraphy showed mild cardiac uptake and significant elevation of serum free lambda chain (with a difference of 263 mg/L in free light chain), we suspected immunoglobulin light-chain amyloidosis (AL), and endomyocardial biopsy was performed.

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Article Synopsis
  • - The study examined 162 patients with hereditary transthyretin amyloidosis (ATTRv) to evaluate the characteristics of TTR-targeted therapy and compare outcomes between combination therapy (gene silencers and TTR stabilizers) and monotherapy.
  • - Patients had an average diagnosis age of 65, with 53% having the V122I variant, and while combination therapy was used by 37% of patients, there were no significant safety issues reported.
  • - Although the combination therapy group showed a tendency for reduced hospitalizations and lower mortality risk compared to monotherapy, the results were not statistically conclusive, indicating a need for more extensive studies for reliable conclusions.
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