The June 8, 2021 session of Duke Medicine LEADS featured a discussion led by Sara Coles, MD; Micah Schub, MD; and Ruchi Doshi, MD, MPH, "An Uncommon Cause of Syncope."
Panelist included, Cristiana Chase, DO; David Leiman, MD; and Michel Khouri, MD, who weighed in for the diagnostic reasoning discussion.
Here are pearls and takeaways from the session:
- Amyloidosis is a spectrum of clinical manifestations due to tissue deposition of misfolded protein into amyloid fibrils and resultant organ dysfunction.
- When concerned about amyloidosis, must delineate which type and organ involvement due to protein (AL vs TTR) and organ (cardiac, renal, GI) specific management
- PYP scan and serum free light chains -> BMBx/EMB versus TTR sequencing.
- Management of AL amyloidosis includes evaluating for multiple myeloma and subsequent chemotherapy depending on presence of myeloma.
- GI manifestations of AL amyloidosis are common, and can include life-threatening GIB, weight loss due to GI dysmotility, or malabsorption/malnourishment.
- There are no guidelines for management of GI amyloidosis, consult your friendly neighborhood gastroenterologist for help!
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.
