She had lost 20 kilogramme within 2 years. Methods: Physical examination: skin and sclera was jaundiced, MI-503 ic50 the liver can be felt 5 cm below the ribs and 4 cm below the xiphoid, which was hard and with rough surface. Laboratory examination results: blood routine: hemoglobin was
108 g/l, liver function: AST 91 U/L, ALP 314 U/L, GGT 176 U/L, ALB 30.1 g/l, TBIL 70.8 umol/l, BIL 49.0 umol/l, IBIL 21.8 umol/l; HAV (-) HBV (-) HCV (-) HEV (-); anti-M2 antibodies (-). Abdominal ultrasound: hepatomegaly, hepatic parenchymal echo was thick and dense. Abdominal CT scan: liver damage, fatty liver was suspected. Liver biopsy: liver amyloidosis, Congo red staining result was postive. Immunohistochemical result showed interstitial amyloid kappa test was strongly positive. Urine light chain detection: KAP was 33.00 mg/24 h.
And serum KAP was 4.41 g/l. The thyroid function: thyrotropin 14.010 uIU/ml, free T3 31.72 pmol/l, free T4 9.06 pmol/l. Bone marrow pucture: Proliferative anemia. Endoscopy: The homogeneous kind substances can be seen in the Lamina propria of gastric body, that Congo red staining was positive. Labial gland biopsy stained with Congo red was negative. Thyroid ultrasound: the thyroid had diffuse change. Echocardiography: the diastolic function of left ventricular declined, Pifithrin-�� supplier which was in line with cardiac amyloidosis echocardiography change. ECG: limb leads was low voltage. Results: According to the relevant examination, the patient diagnosed with primary systemic amyloidosis. In the end, the patient had accepted the MP chemotherapy (melphalan + prednisone). Conclusion: Amyloidosis is that amyloid deposits in the tissue and under the blood vessel wall, which can cause multiple system damage. It can be divided
into primary systemic amyloidosis, secondary systemic amyloidosis, and familial selleck compound transmissibility systemic amyloidosis Primary systemic amyloidosis is amyloid light chain model which is the most common, the disease diagnostic criteria: 1) Two or more organizations stained with Congo red was negative; 2) Exclude tuberculosis, multiple myeloma and so on which was caused by secondary systemic amyloidosis; 3) Immunohistochemical staining proved to be kappa or lambda chain. This disease is rare. In clinical work, physicians are suggested to take this disease into consideration when encounter patients with the syptoms of hepatomegaly, fatigue, weight loss, liver fuction change is inconsistent with hepatomegaly, so as not to delay the treatment. Key Word(s): 1. amyloidosis; 2. hepatomegaly; 3. fatigue; 4.