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- W4226208145 abstract "20年来の1型糖尿病の既往のある75歳男性．患者は抗GAD抗体陽性を示し，高血圧，糖尿病性網膜症，蛋白尿と末梢神経障害を認め，糖尿病性腎症として加療されていた．その後，腎機能障害が進行し血液透析導入となった．透析導入時の入院で体幹の発疹と血中IgA‒λを認め，全身性アミロイドーシスの可能性も考えられたが，胃内視鏡生検ではアミロイドの沈着を認めず，心エコー上も機能は正常であったため否定的と考えた．血液透析直後より低血圧となり，近医で外来透析導入となった後も透析中の血圧低下による透析困難のためしばしば心不全で入院を繰り返し，透析導入後3か月間で心室細動のため死亡した．死因解明のため病理解剖を行い，アミロイドーシスを疑わせる所見を認め，質量分析によりIgA‒λを前駆物質とするALアミロイドーシスの診断に至った．透析導入後短期間に急速に心機能障害が進行した全身性アミロイドーシスの1例を経験したので報告する．" @default.
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- W4226208145 date "2022-01-01" @default.
- W4226208145 modified "2023-10-01" @default.
- W4226208145 title "A case of severe dysdialysis due to heart failure complicated with immunoglobulin lambda‒related systemic amyloidosis" @default.
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- W4226208145 doi "https://doi.org/10.4009/jsdt.55.193" @default.
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