Dual amyloidosis (ATTR wild-type and AL λ) with multisystem involvement
DOI:
https://doi.org/10.32818/reccmi.a11n2a3Keywords:
amyloidosis, fat pad biopsy, cardiac scintigraphyAbstract
Recognition of dual amyloidosis, although rare, carries significant therapeutic implications. We report a 78-yearold
man with new-onset heart failure and echocardiography suggestive of infiltrative cardiomyopathy. Cardiac
scintigraphy showed intense radiotracer uptake. Transthyretin (TTR) gene testing revealed no mutations. Concurrently, an IgG lambda monoclonal gammopathy was detected with 16% plasma cell infiltration in the bone
marrow aspirate. Abdominal fat-pad biopsy confirmed deposition of both lambda light-chain amyloid (AL-λ) and
transthyretin amyloid (ATTR), establishing the diagnosis of stage IIIB dual amyloidosis. This case highlights the
importance of tissue typing to exclude dual amyloidosis, even in patients with scintigraphic highly suggestive of
ATTR.
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Copyright (c) 2026 María Hidalgo-Santamaría, Uxua Idiazabal-Ayesa, Miren Arteaga-Mazuelas, Vanesa Jarne-Betrán, María Luisa Abínzano-Guillen
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