Sarcoidosis and immunoglobulin lambda II light-chain amyloidosis diagnosed after orthotopic heart transplantation

A case report and review of the literature

Diana O. Treaba, Merrill Benson, Lina W. Assad, John R. Dainauskas

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Cardiac involvement by sarcoidosis and concomitant deposition of AL amyloid is an uncommon association. We describe the case of a 53-year-old African-American man with a 7-year history of dilated nonischemic cardiomyopathy and severe cardiac failure who underwent orthotopic heart transplantation. His prior cardiac biopsies had only mild myocyte hypertrophy and minimal interstitial fibrosis. After surgery, numerous sarcoid granulomas and amyloid deposition were identified in the native heart. Six days after the transplant the patient died due to aspiration bronchopneumonia and acute renal failure. At autopsy, both sarcoidosis and immunoglobulin (Ig) lambda light-chain amyloidosis were present in the native atria, lungs, thyroid, liver, spleen, and kidneys. Sarcoid granulomas alone were present in the parathyroids, lymph nodes, and bone marrow. Amyloid deposition alone was present in the aorta, stomach, large bowel, and urinary bladder. There was no evidence of plasma cell dyscrasia, or underlying gammopathy. This unusual association was described in only two other cases in the medical literature. However, this is the first case of sarcoidosis and AL amyloidosis with successful sequencing and identification of Ig lambda light-chain amyloid, and in which there was no evidence of plasma cell dyscrasia.

Original languageEnglish
Pages (from-to)451-455
Number of pages5
JournalModern Pathology
Volume18
Issue number3
DOIs
StatePublished - Mar 2005

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Immunoglobulin lambda-Chains
Amyloidosis
Heart Transplantation
Sarcoidosis
Amyloid
Paraproteinemias
Granuloma
Bronchopneumonia
Dilated Cardiomyopathy
Acute Kidney Injury
African Americans
Muscle Cells
Hypertrophy
Aorta
Autopsy
Stomach
Thyroid Gland
Urinary Bladder
Fibrosis
Spleen

Keywords

  • Amyloidosis
  • Lambda light chain
  • Sarcoid granulomas

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Sarcoidosis and immunoglobulin lambda II light-chain amyloidosis diagnosed after orthotopic heart transplantation : A case report and review of the literature. / Treaba, Diana O.; Benson, Merrill; Assad, Lina W.; Dainauskas, John R.

In: Modern Pathology, Vol. 18, No. 3, 03.2005, p. 451-455.

Research output: Contribution to journalArticle

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