Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Successful management of refractory pleural effusion due to systemic immunoglobulin light chain amyloidosis by vincristine adriamycin dexamethasone chemotherapy: a case report | Araoka et al. Journal of Medical Case Reports 2010 4 322 http content 4 1 322 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Successful management of refractory pleural effusion due to systemic immunoglobulin light chain amyloidosis by vincristine adriamycin dexamethasone chemotherapy a case report 1 2 4 2 2 2 1 Toshikazu Araoka Hiroya Takeoka Keisuke Nishioka Masaki Ikeda Makiko Kondo Azusa Hoshina Seiji Kishi 4 3 111 11 Makoto Araki Rokuro Mimura Taichi Murakami Akira Mima Kojiro Nagai Hideharu Abe Toshio Doi Abstract Introduction Refractory pleural effusion in systemic immunoglobulin light chain amyloidosis without cardiac decompensation is rarely reported and has a poor prognosis in general a median survival of months . Moreover the optimum treatment for this condition is still undecided. This is the first report on the successful use of vincristine adriamycin and dexamethasone chemotherapy for refractory pleural effusion due to systemic immunoglobulin light chain amyloidosis without cardiac decompensation. Case presentation We report the case of a 68-year old Japanese male with systemic immunoglobulin light chain amyloidosis presenting with bilateral pleural effusion more severe on the right side in the absence of cardiac decompensation that was refractory to diuretic therapy. The patient was admitted for fatigue exertional dyspnea and bilateral lower extremity edema. He had been receiving intermittent melphalan and prednisone chemotherapy for seven years. One month before admission his dyspnea had got worse and his chest radiograph showed bilateral pleural effusion the pleural effusion was ascertained to be a transudate. The conventionally used therapeutic measures including diuretics and thoracocentesis failed to control pleural effusion. Administration of vincristine adriamycin and dexamethasone chemotherapy led to successful resolution of the effusion. Conclusion Treatment with vincristine adriamycin and .
