Cardiac amyloidosis: A case report and review of literature

BACKGROUND

Cardiac amyloidosis, a disease caused by the precipitation of amyloid proteins in the myocardial extracellular matrix has been historically difficult to diagnose due to lack of specific clinical manifestations and necessity of biopsy to demonstrate amyloid deposition. However, advances in cardiovascular imaging techniques have facilitated earlier recognition of this disease. In addition, while once thought of as incurable, treatment strategies are emerging for cardiac amyloidosis, making early diagnosis essential.

CASE SUMMARY

We outline the case of a 73 years old African American female who was admitted with sudden onset shortness of breath and found to be in cardiogenic shock. Cardiac amyloidosis was suspected due to discordance between electrocardiogram and echocardiogram findings and this was subsequently confirmed with the aid of scintigraphy and an endomyocardial biopsy.

CONCLUSION

Our objective is to highlight the diagnostic evaluation and clinical implications of cardiac amyloidosis.

Detection of HIV antigen and cDNA among antibody-negative blood samples in Nigeria

In developing countries as many as 50% of patients for whom a transfusion is indicated are at risk of dying immediately if transfusion is withheld. It is therefore important that blood transfusion is made as safe as possible. This study was designed to assess the safety of blood transfusion in two large blood banks in Ibadan, Nigeria. Aliquots of 250 samples already screened and passed as negative for HIV-1 and -2 were collected from each of the blood banks. Samples were tested for the presence of HIV-1 antigen (ELAVIA Ag I) and the antigen-positive samples tested for the presence of specific HIV-1 antibodies by Western blot (BioRad, France). All antigen-positive samples were also subjected to PCR. HIV-1 antigen was detected in 6 (1.2%) of the 500 samples, of which 4 (0.8%) and 3 (0.6%) were Western blot-indeterminate and PCR-positive, respectively. Transfusion of HIV-contaminated blood may be contributing significantly to the spread of the virus in Nigeria. There is therefore an urgent need for an organized blood-banking system with facilities for more sensitive assays for the detection of HIV in blood to prevent transmission through transfusion.

Influence of minerals on the aetiology of geophagia in periurban dairy cattle in the derived savannah of Nigeria

The aetiology of geophagia in periurban dairy cattle in Nigeria was assessed in relation to the mineral status of the serum, the herbage consumed, and the soil from where the herbage was consumed. The study was carried out using nine herds in the derived savannah zone during both the wet and dry seasons. Generally, the Na, Ca, Fe, Zn and Cu levels in the samples were adequate. However, the forages were low in Ca and the serum was deficient in P. Forage, soil and termite hill samples were also deficient in P. The low levels of P in the soil and termite hill samples showed that the consumption of sand by the cattle did not have any positive impact on their P intake. A seasonal effect was apparent (p < 0.05) on the serum Na+, PO4(3-), Cu2+ and Fe2+ concentrations but not on Ca2+ and Zn2+ concentrations. A seasonal effect was also significant (p < 0.05) on the minerals in the forage. There were also seasonal differences in most of the soil and termite hill minerals. Most samples had higher (p < 0.05) mineral levels in the dry season. Herd size and farming activity had no apparent influence on the aetiology of geophagia as they did not affect (p > 0.05) the concentration of P in the serum, the reported cause of geophagia. Geophagia is probably caused by a marginal level of P in the serum and low levels in the forage and soil. Experimental trials will be required to confirm these observations.