Gastrointestinal bleeding from angiodysplasias in patients with aortic stenosis is termed as ‘Heyde’s syndrome’. We report a case of Heyde’s syndrome successfully treated with trans-catheter aortic valve replacement.
Inflammatory myopathies are characterized by the skeletal muscle inflammation leading to symptoms of myopathy along with varying involvement of other organs such as lung, skin and joints. The strong association between inflammatory myopathies and malignancy has been well recognized. Recently, ‘cancer-associated myositis (CAM)’, has been proposed to be a paraneoplastic syndrome due to the anti-tumor immunity secondary to similar tumor and regenerating muscle antigens.As the prognosis of myositis depends on the prognosis and treatment of the underlying malignancy, physicians must determine the degree of testing necessary to detect cancer both at myositis onset and thereafter. However, there are no clear guidelines regarding the best approach. Emerging medical evidence shows that identification of certain risk factors and serology patterns can be utilized to predict cancer risk in patients with myositis.
PTU can cause ANCAassociated vasculitis resulting in multiorgan failure. Plasmapheresis should be held for 3 days after rituximab infusion in order to allow maximum exposure. The second dose of rituximab may be given before the recommended 7-day interval in cases in which plasmapheresis is being performed to maximize therapeutic benefit.
Light chain amyloidosis has very rarely been reported in association with chronic lymphocytic leukemia (CLL). We reported on a 76-years-old female who presented with simultaneous kappa-restricted chronic lymphocytic leukemia (CLL) and a lambda-restricted multiple myeloma with plasma cells causing AL amyloidosis involving the heart. While monoclonal immunoglobulins occasionallyproduced by CLL have previously been implicated in AL amyloidosis, there only a few cases reported of AL amyloidosis resulting from a distinct plasma cell dyscrasia that is not clonally related to the concurrent CLL.
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