Giant Hepatomegaly with Spleno-testicular Enlargement in a Patient with Apolipoprotein A-I Amyloidosis: An Uncommon Type of Amyloidosis in Japan

载脂蛋白 AI 淀粉样变性患者出现巨肝肿大,伴有脾脏睾丸肿大:日本一种罕见的淀粉样变性类型

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作者:Tsuneaki Yoshinaga, Nagaaki Katoh, Masahide Yazaki, Mitsuto Sato, Fuyuki Kametani, Hideo Yasuda, Kyohei Watanabe, Kazuhito Kawata, Mayuko Nakagawa, Yoshiki Sekijima

Abstract

Hereditary systemic amyloidosis aside from transthyretin-related familial amyloid polyneuropathy is quite uncommon in Japan. We herein report a sporadic case of hereditary apolipoprotein A-I (apoAI) amyloidosis. The patient was a 43-year-old Japanese man who exhibited marked hepatomegaly with spleno-testicular enlargement. While he was initially thought to have primary AL amyloidosis, a proteomics analysis revealed that the amyloid was composed of variant apoAI with an E34K variant. To date, only one patient with apoAI amyloidosis has been reported in Japan. However, our study suggests that more patients may be present in Japan, and the majority may have been diagnosed with other types of amyloidosis due to its clinical similarity.

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