A Case of Cardiac Amyloidosis With Diuretic-Refractory Pleural Effusions Treated With Bevacizumab.
10.4070/kcj.2010.40.12.671
- Author:
Suk Hyang BAE
1
;
Jin Yeon HWANG
;
Woo Jae KIM
;
Hyun Hwa YOON
;
Jung Min KIM
;
Young Hee NAM
;
Hee Gyung BAEK
;
Yong Rak CHO
;
Sun Yi PARK
;
Jeong Hwan KIM
;
Sung Hyun KIM
;
Tae Ho PARK
;
Gi Nam LEE
;
Seo Hee RHA
;
Young Dae KIM
Author Information
1. Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. kimyd@mail.donga.ac.kr
- Publication Type:Case Report
- Keywords:
Heart disease;
Amyloidosis;
Pleural effusion;
Bevacizumab
- MeSH:
Amyloid;
Amyloidosis;
Antibodies, Monoclonal, Humanized;
Drainage;
Female;
Heart;
Heart Diseases;
Heart Failure;
Humans;
Pleural Effusion;
Prognosis;
Sodium Potassium Chloride Symporter Inhibitors;
Vascular Endothelial Growth Factor A;
Bevacizumab
- From:Korean Circulation Journal
2010;40(12):671-676
- CountryRepublic of Korea
- Language:English
-
Abstract:
Cardiac amyloidosis describes a clinical disorder caused by infiltration of abnormal insoluble fibrils in the heart, characterized by progressive heart failure and a grave prognosis. Pleural effusion in cardiac amyloidosis may represent a sign of heart failure, but it can also result from pleural infiltration of amyloid, manifested by recurrent large fluid accumulations. Recently, the role of vascular endothelial growth factor (VEGF) has been implicated in the pathogenesis of refractory pleural effusion. We report a case of a 53 year-old female patient with cardiac amyloidosis who presented with recurrent accumulation of large pleural effusions. She was initially treated with high dose loop diuretics, but the pleural effusion persisted, with the daily amount of drainage averaging 1 L/day. Accumulation of pleural fluid did not subside after 3 cycles of melphalan/prednisolone therapy. After the introduction of bevacizumab, an anti-VEGF antibody, the amount of pleural effusion decreased significantly. Efficacy of anti-VEGF therapy for refractory pleural effusions needs to be defined through further studies.
