Monoclonal gammopathy progressing to systemic amyloidosis with cardiac involvement. A case report

TL;DR

This case report describes a patient with a monoclonal gammopathy that progressed to amyloidosis affecting the heart, and the successful treatment approach used.

Contribution

The novelty lies in presenting a rare progression from monoclonal gammopathy to cardiac amyloidosis and the treatment outcomes.

Findings

The patient's diagnosis was confirmed by elevated free light chains and amyloid deposits in fat and gastrointestinal tract.

Treatment with daratumumab, bortezomib, and dexamethasab, followed by stem cell transplantation, led to a favorable outcome.

Cardiac involvement was a key clinical feature in this case of systemic amyloidosis.

Abstract

We report a case of systemic light chain amyloidosis with cardiac involvement, preceded by a monoclonal IgG lambda gammopathy. The clinical diagnosis was based on signs of heart failure, elevated cardiac biomarkers, and characteristic imaging findings. The diagnosis was confirmed by increased levels of free light chains in blood and urine, as well as the presence of amyloid deposits in periumbilical fat and multiple segments of the gastrointestinal tract. Treatment with daratumumab, bortezomib, and dexamethasone was initiated, followed by autologous hematopoietic stem cell transplantation 22 months after diagnosis, resulting in a favourable clinical outcome.

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