Late-onset Transthyretin (TTR)-familial Amyloid Polyneuropathy (FAP) with a Long Disease Duration from Non-endemic Areas in Japan.

Abstract

We herein report the case of an 84-year-old woman with transthyretin (TTR) Val30Met-associated familial amyloid polyneuropathy (FAP-ATTR Val30Met), representing a very old case. The patient had muscle weakness and sensory disturbances in her extremities caused by severe peripheral neuropathy. She also had vitreous opacity and orthostatic hypotension, and pyrophosphate scintigraphy showed a myocardial accumulation. Esophagogastroduodenoscopy revealed mucosal amyloid deposits, positive in anti-TTR antibody staining. A TTR gene analysis isolated the Val30Met mutation. More than a few cases of FAP-ATTR develop late, like our own, and their familial histories are often obscure in non-endemic areas, which might make a diagnosis difficult.

• Authors: Zenshi Miyake, Kiyotaka Nakamagoe, Naoki Ezawa, Tsuneaki Yoshinaga, Ryosuke Hashimoto, Taiki Sato, Yoshiki Sekijima, Akira Tamaoka
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 58 Issue 5 Pg. 713-718 (Mar 01 2019) ISSN: 1349-7235 [Electronic] Japan
• PMID: 30333406 (Publication Type: Case Reports, Journal Article)

Chemical References

• Amyloid
• Prealbumin
• TTR protein, human

Topics

• Aged, 80 and over
• Amyloid (analysis)
• Amyloid Neuropathies, Familial (complications, diagnosis, genetics)
• Cardiomyopathies (diagnosis, genetics)
• Eye Diseases (etiology)
• Female
• Humans
• Hypotension, Orthostatic (etiology)
• Mutation
• Prealbumin (genetics)
• Radionuclide Imaging
• Vitreous Body