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CASE REPORT
Year : 2016  |  Volume : 21  |  Issue : 1  |  Page : 117

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


1 Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
2 Department of Neurological Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
3 Department of Physiatry and Rheumatology, Division of Rheumatology, Istituto Ortopedico Gaetano Pini, Milan, Italy

Correspondence Address:
Lorena Airaghi
Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1735-1995.193508

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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.


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