Difficulties in diagnosing and treating AL amyloidosis: a case from practice
O. V. Fesenko,
N. B. Lyapkova,
A. Yu. Osminina,
M. Yu. Chernov,
V. P. Romanov,
A. N. Fursov,
M. V. Drozd,
V. P. Pop https://doi.org/10.18093/0869-0189-2025-35-4-568-576
Abstract
The term “amyloidosis” unites a group of rare diseases characterized by extracellular deposition of an insoluble fibrillar protein amyloid. Light chain amyloidosis (AL amyloidosis) is one of the most common and severe forms of this pathology that affects the heart (in the vast majority of patients), kidneys, gastrointestinal tract, nervous system, and skin. Without treatment, it takes from 6 to 12 months from the appearance of the first symptoms of heart damage to death. The diagnosis of AL amyloidosis is challenging due to the variety and non-specific nature of clinical manifestations and the need for morphological verification of the diagnosis. The possibilities of treating amyloidosis have significantly expanded recently and have made it possible to radically change the prognosis of the disease. However, the therapy can only take full effect with early diagnosis and the absence of irreversible organ damage.
The aim of the work is to demonstrate the complexity of diagnosis of this condition and the available treatments for the timely identified AL amyloidosis.
Conclusion. The presented clinical case demonstrates the potential of a multidisciplinary approach for early diagnosis and treatment of AL amyloidosis.
About the Authors
O. V. Fesenko
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation;
Federal State Budgetary Educational Institution of Additional Professional Education “Russian Medical Academy of Continuous Professional Education”, Ministry of Health of Russia
Russian Federation
Russian Federation
Oksana V. Fesenko, Doctor of Medicine, Pulmonologist-consultant, Main Military Clinical Hospital named after academician N.N.Burdenko,; Professor, Pulmonology Department, Russian Medical Academy of Continuous Professional Education
Gospital’naya pl. 3, Moscow, 105229;
ul. Barrikadnaya 2/1, build. 1, Moscow, 123995
N. B. Lyapkova
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Nataliya B. Lyapkova, Candidate of Medicine, Cardiologist
Gospital’naya pl. 3, Moscow, 105229
A. Yu. Osminina
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Anzhela Yu. Osminina, Head of the Laboratory, Center for Functional Diagnostic Research
Gospital’naya pl. 3, Moscow, 105229
M. Yu. Chernov
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Mikhail Yu. Chernov, Physician of Functional Diagnostics, Center for Functional Diagnostic Research
Gospital’naya pl. 3, Moscow, 105229
V. P. Romanov
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Vadim P. Romanov, Head of the Nephrology Department
Gospital’naya pl. 3, Moscow, 105229
A. N. Fursov
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Andrey N. Fursov, Doctor of Medicine, Professor, Head of the Cardiology Department
Gospital’naya pl. 3, Moscow, 105229
M. V. Drozd
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Mariya V. Drozd, Hematologist
Gospital’naya pl. 3, Moscow, 105229
V. P. Pop
Main Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Vasiliy P. Pop, Candidate of Medicine, Head of the Department of High-Dose Chemotherapy and Bone Marrow Transplantation
Gospital’naya pl. 3, Moscow, 105229
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Review
For citations:
Fesenko O.V., Lyapkova N.B., Osminina A.Yu., Chernov M.Yu., Romanov V.P., Fursov A.N., Drozd M.V., Pop V.P. Difficulties in diagnosing and treating AL amyloidosis: a case from practice. PULMONOLOGIYA. 2025;35(4):568-576. (In Russ.) https://doi.org/10.18093/0869-0189-2025-35-4-568-576
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