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Case Records of the Massachusetts General Hospital
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Volume 352:2111-2119 May 19, 2005 Number 20
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Case 15-2005 — An 80-Year-Old Man with Shortness of Breath, Edema, and Proteinuria
Laura M. Dember, M.D., Jo-Anne O. Shepard, M.D., Francesca Nesta, M.D., and James R. Stone, M.D., Ph.D.

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Presentation of Case

An 80-year-old man was admitted to the hospital because of shortness of breath, pleural effusions, and edema of the legs.

Atrial fibrillation had developed seven years earlier, with bradycardia and syncope, and a pacemaker had been placed. Angina developed two and a half years before admission and was treated with three-vessel coronary-artery bypass grafting. The patient had several episodes of congestive heart failure thereafter. Eleven months before admission, urinalysis revealed 3+ proteinuria, an increase from 1+ one year earlier. Nine months before admission, a subtotal colectomy was performed because of ischemic colitis with bleeding. Bilateral pleural effusions, pulmonary edema, and . . . [Full Text of this Article]

Differential Diagnosis

Causes of the Nephrotic Syndrome

Organ Dysfunction in Systemic Amyloidosis

Types of Systemic Amyloidosis

Nonamyloid Immunoglobulin Deposition Diseases

Clinical Diagnosis

Dr. Laura M. Dember's Diagnosis

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Renal Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine (L.M.D.); the Departments of Radiology (J.O.S.), Cardiology (F.N.), and Pathology (J.R.S.), Massachusetts General Hospital; and the Departments of Radiology (J.O.S.), Cardiology (F.N.), and Pathology (J.R.S.), Harvard Medical School — all in Boston.




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