Progressively invalidating orthostatic hypotension: A common symptom for a challenging diagnosis

• Main Authors: Serena Pelusi, Rosa Lombardi, Lorena Airaghi, Larry Burdick, Mario Rango, Alessandra Penatti, Silvia Fargion
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Journal of Research in Medical Sciences
• Subjects: Amyloidosis; multiple myeloma; refractory hypotension; restrictive cardiomyopathy; tilt test
• Online Access: http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2016;volume=21;issue=1;spage=117;epage=117;aulast=Pelusi

We discuss here an uncommon condition of neurogenic hypotension in the context of immunoglobulin light chain (amyloid light-chain) amyloidosis. The most serious feature was autonomic nervous system impairment, mainly characterized by severe refractory orthostatic hypotension, which became progressively invalidating, forcing the patient to bed. Moreover, since the systemic involvement of the disease, the patient presented also diarrhea, dysphagia, asthenia, peripheral edema because of gastrointestinal, and kidney dysfunction. Eventually, the massive myocardial depression and infiltration led to a fatal outcome.