Cardiac noradrenergic denervation in a patient with multiple symmetric lipomatosis.

Abstract

INTRODUCTION:

Multiple symmetric lipomatosis (MSL) is a rare disease of unknown etiology characterized by multiple subcutaneous lipomas with a symmetrical distribution. One interesting aspect about MSL is a high incidence of sudden cardiac death despite a low incidence of metabolic syndrome and coronary arterial disease. Autonomic nervous system dysfunction may probably explain this feature of MSL.

CASE REPORT:

A 74-year-old man was admitted with acute heart failure and atrial fibrillation. He had a morphotype suggestive of MLS. A (123)I-metaiodobenzylguanidine myocardial scintigraphy was conducted for evaluation of cardiac autonomic nervous integrity, since atrial fibrillation precluded the classical approach. The heart-to-mediastinum ratio was 1.68 (normal >2.2). Ischemia was not detected in myocardial perfusion scintigraphy.

CONCLUSION:

We present the first reported case of MSL autonomic neuropathy detected by (123)I- metaiodobenzylguanidine scintigraphy and suggest that this approach could play a role in MSL stratification by risk of sudden cardiac death and in exploring MSL disease mechanisms.

• Authors: Válter R Fonseca, Carlos Freitas, Mireille Palmeira, Carlos Ferreira, Rui Victorino
• Journal: Cardiology (Cardiology) Vol. 121 Issue 3 Pg. 160-3 ( 2012) ISSN: 1421-9751 [Electronic] Switzerland
• PMID: 22441442 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2012 S. Karger AG, Basel.

Chemical References

• Radiopharmaceuticals
• 3-Iodobenzylguanidine

Topics

• 3-Iodobenzylguanidine
• Aged
• Arrhythmias, Cardiac (etiology)
• Autonomic Nervous System Diseases (diagnostic imaging, etiology)
• Denervation
• Dyspnea (etiology)
• Heart (innervation)
• Humans
• Lipomatosis, Multiple Symmetrical (complications, diagnostic imaging)
• Male
• Radionuclide Imaging
• Radiopharmaceuticals