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Postural hypotension in amyloid disease
Authors:D Gaan  M P Mahoney  D J Rowlands  A W Jones
Affiliation:1. College of Chemistry and Chemical Engineering, Jishou University, Hunan 416000, China;2. Key Laboratory of Mineral Cleaner Production and Exploit of Green Functional Materials in Hunan Province, Jishou University, Jishou 416000, PR China;3. State Key Laboratory of Chemo/Biosensing and Chemometrics, Hunan University, Changsha 410082, PR China;1. Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada;2. Northern Care Alliance NHS Foundation Trust, Salford Care Organisation, Salford, UK;3. Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK;4. Manchester, United Kingdom;5. Adelaide, Australia;6. Discipline of Medicine, University of Adelaide and Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia;7. Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA;8. North Bristol NHS Trust, Bristol, UK;9. Bristol Medical School, University of Bristol, Bristol, UK
Abstract:A patient with primary amyloidosis who developed severe postural hypotension during the course of the nephrotic syndrome is described; hemodynamic studies demonstrated that this was due to autonomic dysfunction and revealed evidence of central and peripheral cardiovascular denervation. Pathological examination showed extensive infiltration of sympathetic ganglia and nerves with amyloid material. Postural hypotension was the only clinical evidence of neurological involvement in the absence of other manifestations of autonomic disturbance or signs of peripheral neuropathy.
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