Primary amyloidosis differential diagnosis: Difference between revisions
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| style="background: #4479BA; width: 200px;" |{{fontcolor|#FFF|'''Therapy'''}} | | style="background: #4479BA; width: 200px;" |{{fontcolor|#FFF|'''Therapy'''}} | ||
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| rowspan=" | | rowspan="5" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''''Cardiac Failure''''' | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Cardiac amyloidosis (AL and ATTRwt) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Cardiac amyloidosis (AL and ATTRwt) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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* Dexamethasone plus Cyclophosphamide-thalidomide | * Dexamethasone plus Cyclophosphamide-thalidomide | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hypertrophic obstructive cardiomyopathy | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Hypertrophic obstructive cardiomyopathy]] | ||
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* Mutation in sarcomeric protein (beta myosin heavy chain and myosin binding protein C) | *[[Mutations|Mutation]] in sarcomeric protein (beta myosin heavy chain and myosin binding protein C) | ||
* Autosomal dominant inheritance | *[[Autosomal dominant]] inheritance | ||
* | * | ||
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** | ** | ||
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* Increased BNP | * Increased [[Brain natriuretic peptide|BNP]] | ||
* Increased creatine kinase | * Increased [[creatine kinase]] | ||
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* Echocardiography: | * Echocardiography: | ||
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* [[Septal myectomy]] | * [[Septal myectomy]] | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Alcoholic cardiomyopathy | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Alcoholic cardiomyopathy]] | ||
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* Alcohol consumption | |||
* | * | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Exercise intolerance]] | |||
*[[Fainting]], [[presyncope]] or frank [[syncope]], especially during exercise | |||
*[[Fatigue]]) | |||
*[[Light-headedness]] | |||
*[[Shortness of breath]] | |||
*[[Reduced activity tolerance]] | |||
*[[Shortness of breath]] | |||
* | * | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" |<br /> | ||
* Elevated [[mean corpuscular volume]] ([[MCV]]) and [[mean corpuscular hemoglobin]] (MCHC) | |||
* Mild [[thrombocytopenia]] | |||
* Elevated [[LDH]], [[AST]], [[ALT]], [[creatine kinase]], malic dehydrogenase and alpha-hydroxybutyric dehydrogenase | |||
* Elevated gammaglutamyl transpeptidase | |||
* Serum concentrations of [[magnesium]] and [[zinc]] may be reduced | |||
<br /> | |||
* | * | ||
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* [[Endomyocardial biopsy]] | |||
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* Restriction of dietary salt | |||
* [[ACE inhibitor|ACE inhibitors]] or [[angiotensin II receptor blockers]] | |||
* [[Beta blockers]] | |||
* [[Diuretics]] | |||
* [[Digoxin]] | |||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |ST-elevation myocardial infarction | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[ST elevation myocardial infarction|ST-elevation myocardial infarction]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Myocardial ischemia]] | |||
* [[Atherosclerosis]] | |||
* | * | ||
| | | | ||
* [[Exercise intolerance]] | |||
*[[Fainting]], [[presyncope]] or frank [[syncope]], especially during exercise | |||
*[[Fatigue]]) | |||
*[[Light-headedness]] | |||
*[[Shortness of breath]] | |||
*[[Reduced activity tolerance]] | |||
*[[Shortness of breath]] | |||
| | | | ||
| | * Increased [[Cardiac troponin|cardiac troponins]] | ||
| | * Increased [[Lactate dehydrogenase|LDH]] | ||
* [[Leukocytosis]] | |||
* | * [[ST segment elevation]] on EKG | ||
| | | | ||
* Elevation of [[Cardiac troponin|cardiac troponins]] | |||
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* Percutaneous coronary intervention or coronary artery bypass graft | |||
* [[Aspirin]] | |||
* [[Clopidogrel]] | |||
* [[Beta blockers]] | |||
* [[Diuretics]] | |||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Pericarditis]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[HIV]] | |||
* [[Dressler's syndrome]] | |||
* [[Tuberculosis]] | |||
* [[Uremia]] | |||
* [[Radiation]] | |||
* [[Malignancy]] | |||
* | * | ||
|<br /> | |||
* [[Chest pain]] (relieved by sitting up and leaning forward and is worsened by lying down) | |||
* [[Cough]] (either dry or productive) | |||
* [[Fever]] | |||
* [[Fatigue]] | |||
* [[Anxiety]] | |||
* [[Breathlessness]] | |||
<br /> | |||
|<br /> | |||
* [[Creatine kinase]]: [[Acute pericarditis]] may be associated with a modest increase in serum [[creatine kinase]]-MB (CK-MB) depending upon the extent of involvement of the underlying [[myocardium]]. | |||
* Increased [[Cardiac troponin I (cTnI) and T (cTnT)|cardiac troponin-I (cTnI)]] | |||
* Increased [[LDH]] | |||
* Increased serum [[myoglobin]] | |||
* Increased [[SGOT]] ([[AST]]) | |||
<br /> | |||
| | |||
* Two of the following four criteria: | |||
** Pericarditic chest pain | |||
** [[Pericardial rubs|Pericardial rub]] | |||
** New widespread [[ST-segment elevation]] or [[PR depression]] | |||
** New or worsening [[pericardial effusion]]. | |||
* Supporting findings can include elevation of inflammatory markers ([[C-reactive protein (CRP)|C-reactive protein]], [[Erythrocyte sedimentation rate|ESR]], [[white blood cell count]]), and evidence of pericardial inflammation on imaging([[Computed tomography|CT scan]] and [[cardiac MRI]]). | |||
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Revision as of 19:49, 30 October 2019
Primary amyloidosis Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Primary amyloidosis differential diagnosis On the Web |
American Roentgen Ray Society Images of Primary amyloidosis differential diagnosis |
Risk calculators and risk factors for Primary amyloidosis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
- Differentiating Primary amyloidosis from Other Diseases
Organ System Involvement | Differential Diagnosis | Causes | Clinical Features | Laboratory Findings | Gold Standard Test | Therapy |
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Nephrotic Syndrome and Real Failure | Primary (AL) Amyloidosis |
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Diabetic Nephropathy |
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Minimal Change Disease |
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Focal Segmental Glomerulosclerosis | ||||||
Fabry's Disease |
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Light Chain Deposition Disease |
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Membranous Glomerulonephritis |
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Fibrillary-Immunotactoid Glomerulopathy |
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Organ System Involvement | Differential Diagnosis | Causes | Clinical Features | Laboratory Findings | Gold Standard Test | Therapy |
Polyneuropathy | POEMS syndrome (Demyelinating) |
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Metabolic Syndrome (Axonal pathology) |
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Vitamin Deficiencies (Axonal Pathology) |
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Guillain-Barre Syndrome (Demyelinating) |
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Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) (Mixed axonal and demyelinatiing) |
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Multifocal Motor Neuropathy |
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Organ System Involvement | Differential Diagnosis | Causes | Features | Laboratory Findings | Gold Standard Test | Therapy |
Organomegaly (Hepatosplenomegaly and Lymphadenopathy) | Malaria |
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Kala-azar |
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Infective Hepatitis |
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Chronic Myelogenous Leukemia (CML) |
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Lymphoma |
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Primary (AL) Amyloidosis |
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Gaucher's Disease |
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Organ System Involvement | Differential Diagnosis | Causes | Features | Laboratory Findings | Gold Standard Test | Therapy |
Cardiac Failure | Cardiac amyloidosis (AL and ATTRwt) |
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Hypertrophic obstructive cardiomyopathy |
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Alcoholic cardiomyopathy |
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ST-elevation myocardial infarction |
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Pericarditis |
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Organ System Involvement | Differential Diagnosis | Causes | Features | Laboratory Findings | Gold Standard Test | Therapy |
Plasma Cell Dyscrasias | Multiple myeloma |
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AND
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Monoclonal gammopathy of undetermined significance (MGUS) |
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AND
AND
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Asymptomatic Plasma Cell Myeloma |
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OR
AND/OR
AND
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Plasmacytoma |
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Skin Changes | Scurvy |
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