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KMID : 0356620080230050332
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Journal of Korean Society of Endocrinology
2008 Volume.23 No. 5 p.332 ~ p.336
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A Patient with Primary Amyloidosis Misrecognized as Thyrotoxicosis-induced Heart Failure
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Lee Seok-Ju
Lee Seung-Hwan
Chin Jung-Yeon
Song Youn-Mi
Lee Sung-Won
Kim Min-Hee
Kang Mi-Ja
Lee Kang-Woo
Kwon Hyeok-Sang
Yoon Kun-Ho
Son Ho-Young
Cha Bong-Yun
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Abstract
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Amyloidosis is caused by deposition of insoluble amyloid protein in the extracellular space of organs and tissues. The causes of amyloidosis are classified as primary, secondary, and hereditary, and symptoms develop according to which organ is involved. Cardiac amyloidosis induces cardiomyopathy and is developed by deposition of amyloid proteins in cardiac tissue. We diagnosed a patient with rhabdomyolysis and thyrotoxicosis with underlying Graves` disease 5 years ago. The patient was readmitted recently complaining of general weakness and mild dyspnea, and was diagnosed as relapsed thyrotoxicosis. An echocardiogram was performed for the evaluation of dyspnea and the findings were compatible with infiltrative cardiomyopathy due to amyloidosis. A biopsy of the abdominal subcutaneous fat and rectal mucosa was performed, and diagnosis was amyloidosis with histologic findings. The cause of heart failure was therefore cardiac amyloidosis rather than thyrotoxicosis. This case indicates the importance of evaluating the cause of heart failure in patients with thyrotoxicosis.
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KEYWORD
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cardiac amyloidosis, Graves` disease, heart failure, thyrotoxi
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