1.A case of referred pain in end-stage primary generalized amyloid light-chain amyloidosis effectively treated by ketamine
Tomoyo Kajino ; Kyouko Yanagida ; Norio Yoshida ; Norio Takimoto ; Takashi Sakakibara ; Masako Makino ; Marina Takagi ; Masanao Miura ; Fujio Nakamura
Palliative Care Research 2012;7(2):581-584
Introduction: Amyloidosis is a variety of symptoms, such as organ failure and peripheral neuropathy amyroid protein is deposited in the systemic organs. We report a case of ketamine was effective for vulba referred pain in end stage. Case report: A 72-year-old male patient in end-stage primary generalized amyloid light-chain amyloidosis experienced excruciating pain in his genitalia about four times daily, lasting from tens of seconds to three minutes. No abnormal findings were noted in the genitalia. Bowel movement and large amounts of peritoneal dialysis fluid triggered excessive traction of the glans penis, which caused the excruciating pain. Referred pain originating from the pelvic plexus was suspected. Continuous infusion of ketamine was started at 50 mg/day for pain relief, which eliminated his pain, and the patient passed away 17 days later. Conclusion: The reason a small dosage of ketamine was effective, we consider there is a possibility of recovery from central sensitization effect of NMDA receptor antagonist worked effectively.
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