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Lingual liability: macroglossia and dyspnoea as the harbinger of systemic AL (light-chain) cardiac amyloidosis.
BMJ Case Rep. 2018 Dec 22; 11(1)BC

Abstract

A 58-year-old man presented with a chief complaint of tongue indentations and discomfort. Otolaryngology treated him for oral thrush with counselling to avoid tongue biting. In addition, the patient reported dyspnoea described as a decrease in tolerance of his physical activities. Due to continued increase in tongue size and worsening dyspnoea, he underwent a tissue biopsy with findings consistent with amyloidosis. Further evaluation with a bone marrow biopsy revealed underlying multiple myeloma. Echocardiography revealed abnormal ventricular wall thickness, with a reduced left ventricular chamber size, dilated atria and Doppler findings with restrictive filling patterns indicative of cardiac amyloidosis. The patient was initiated on chemotherapy for his multiple myeloma and supportive therapy for his cardiac amyloidosis. Light-chain amyloidosis (AL) is a systemic disease characterised by irreversible deposition of amyloid in tissues throughout the body; when there is cardiac involvement, it can result in heart failure with a poor prognosis. Early diagnosis of cardiac amyloidosis can lead to prolonged survival.

Authors+Show Affiliations

Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA.Department of Medicine, Tripler Army Medical Center, Tripler, Hawaii, USA.Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA.Division of Cardiology, Tripler Army Medical Center, Tripler, Hawaii, USA.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30580294

Citation

Williams, Michael Uncle, et al. "Lingual Liability: Macroglossia and Dyspnoea as the Harbinger of Systemic AL (light-chain) Cardiac Amyloidosis." BMJ Case Reports, vol. 11, no. 1, 2018.
Williams MU, Murphy CE, Gore RS, et al. Lingual liability: macroglossia and dyspnoea as the harbinger of systemic AL (light-chain) cardiac amyloidosis. BMJ Case Rep. 2018;11(1).
Williams, M. U., Murphy, C. E., Gore, R. S., & Fentanes, E. (2018). Lingual liability: macroglossia and dyspnoea as the harbinger of systemic AL (light-chain) cardiac amyloidosis. BMJ Case Reports, 11(1). https://doi.org/10.1136/bcr-2018-225923
Williams MU, et al. Lingual Liability: Macroglossia and Dyspnoea as the Harbinger of Systemic AL (light-chain) Cardiac Amyloidosis. BMJ Case Rep. 2018 Dec 22;11(1) PubMed PMID: 30580294.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lingual liability: macroglossia and dyspnoea as the harbinger of systemic AL (light-chain) cardiac amyloidosis. AU - Williams,Michael Uncle, AU - Murphy,Caroline E, AU - Gore,Rosco Steven, AU - Fentanes,Emilio, Y1 - 2018/12/22/ PY - 2018/12/24/entrez PY - 2018/12/24/pubmed PY - 2019/4/6/medline KW - cardiovascular medicine KW - medical education KW - oncology KW - ophthalmology KW - otolaryngology / ENT JF - BMJ case reports JO - BMJ Case Rep VL - 11 IS - 1 N2 - A 58-year-old man presented with a chief complaint of tongue indentations and discomfort. Otolaryngology treated him for oral thrush with counselling to avoid tongue biting. In addition, the patient reported dyspnoea described as a decrease in tolerance of his physical activities. Due to continued increase in tongue size and worsening dyspnoea, he underwent a tissue biopsy with findings consistent with amyloidosis. Further evaluation with a bone marrow biopsy revealed underlying multiple myeloma. Echocardiography revealed abnormal ventricular wall thickness, with a reduced left ventricular chamber size, dilated atria and Doppler findings with restrictive filling patterns indicative of cardiac amyloidosis. The patient was initiated on chemotherapy for his multiple myeloma and supportive therapy for his cardiac amyloidosis. Light-chain amyloidosis (AL) is a systemic disease characterised by irreversible deposition of amyloid in tissues throughout the body; when there is cardiac involvement, it can result in heart failure with a poor prognosis. Early diagnosis of cardiac amyloidosis can lead to prolonged survival. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/30580294/Lingual_liability:_macroglossia_and_dyspnoea_as_the_harbinger_of_systemic_AL__light_chain__cardiac_amyloidosis_ L2 - https://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=30580294 DB - PRIME DP - Unbound Medicine ER -