A 72-year-old woman with orthostatic hypotension, syncope, and marked proteinuria

Article Abstract:

A 72-year-old woman was diagnosed with amyloidosis involving the heart, kidney, lungs and autonomic nerves. Amyloidosis is a disorder characterized by the accumulation of amyloid, a fiber-like protein, in different organs and tissues. The patient was admitted to the hospital with low blood pressure while standing, recurrent fainting attacks and high levels of protein in her urine. She experienced dizziness while standing and loss of appetite beginning about three months before her hospital admission. She had been treated for many years with drugs for high blood pressure, but she had discontinued treatment several years before admission to the hospital. A biopsy of abdominal fat revealed that she was suffering from systemic amyloidosis. The patient died from heart failure seven days after admission. An autopsy revealed accumulation of protein in her heart, lungs, kidneys and blood vessels.

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A 66-year-old woman with diabetes, coronary disease, orthostatic hypotension, and the nephrotic syndrome

Article Abstract:

A 66-year-old woman was admitted to a hospital because of frequent fainting. This occurred despite a pacemaker she had received the year before because of chronic fainting. She had a type of kidney disease called nephrotic syndrome as well as a history of type 2 diabetes and coronary artery disease. An echocardiogram showed that she had restrictive cardiomyopathy, a heart disease that prevents the heart from beating normally. Her doctors suspected that she had amyloidosis, which is caused by abnormal deposits of amyloid in various organs. She died, and this diagnosis was confirmed at autopsy.

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A 31-year-old woman with a pleural effusion, ascites, and persistent fever spikes

Article Abstract:

A 31-year-old woman with fever, cough, and fluid around her lungs and in her abdomen entered the hospital for care. Blood and pleural fluid cultured negative for bacteria, but a tuberculin skin test was positive. A possible history of vaccination during childhood in Cambodia complicated the diagnostic value of the skin test. Doctors treated the patient with antituberculous drugs while continuing testing. A biopsy from within the abdomen confirmed that the patient had peritoneal tuberculosis. Diagnosis of this disease is difficult because some tests may not reveal the organism.

Tuberculosis

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