心アミロイドーシスの診療アルゴリズムにもあるように、M蛋白の検出とピロリン酸シンチは心アミロイドーシスのサブタイプ診断の重要な両翼である。しかし、これは当院でピロリン酸シンチが導入される前に発生した症例であるため、KUMAMOTOクライテリアでは1点であったが、心アミロイドーシスを疑うred flag所見（高齢男性心不全、伝導障害、心室中隔肥厚、軽度トロポニン上昇）を認めたため、まずは低侵襲の組織学的診断から行うことを推奨した。
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- Posted at 15 Mar 2022 at 19:41
As the cardiac amyloidosis' clinical algorithm shows, M protein and pyrophosphate scintigraphy detection are important wings in the subtype diagnosis of cardiac amyloidosis. However, this is, in our hospital, a case occurred before introduction of pyrophosphate scintigraphy, and it was only one point in the KUMAMOTO criteria, however it showed red flag findings (elderly male heart failure, conduction disorder, interventricular septum) in suspicious of cardiac amyloidosis and so it was recommended to start with a minimally invasive histological diagnosis.
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50
Translation / English
- Posted at 15 Mar 2022 at 19:49
As in practice algorithm of cardiac amyloidosis, M protein detection and Pyrophosphoric acid scintigraphy are important both wings for subtypes diagnosis of cardiac amyloidosis. However, since it is a case that had occurred before Pyrophosphoric acid scintigraphy was installed in this hospital, and red flag finding suspecting cardiac amyloidosis (elderly male cardiac insufficiency, conduction disturbance, thickening of the interventricular septum and troponin increase) though 1 point in KURAMOTO criteria, first I recommended to conduct minimally invasive histological diagnosis.
