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Management of Tracheobronchial Amyloidosis With Therapeutic Bronchoscopic Techniques
Authors:Javier Berraondo  Laura Novella  Francisco Sanz  Rafael Lluch  Enrique de Casimiro  Tomás Lloret
Affiliation:1. HealthPartners Institute for Education and Research, Minneapolis, MN, USA;2. Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;1. Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;2. Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taiwan;3. Department of Life Sciences, National Central University, Taoyuan City, Taiwan;4. Division of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;5. Division of Otolaryngology-Head and Neck Surgery, Taoyuan Armed Forces General Hospital, Taiwan;6. Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City, Taiwan;7. Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli County, Taiwan;8. Graduate Program for Aging, China Medical University, Taichung City, Taiwan;9. Division of Otolaryngology-Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;1. MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital of Neurology and Neurosurgery, Queen Square, London, UK;2. University Hospital “Marqués de Valdecilla”, Department of Neurology, Santander, Spain;3. Division of Neuropathology, UCL Institute of Neurology and National Hospital of Neurology and Neurosurgery, Queen Square, London, UK;4. National Amyloidosis Centre, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK;5. Department of Clinical Neurophysiology, Norfolk and Norwich University Hospital, Norwich, UK
Abstract:Amyloidosis is a systemic disease caused by abnormal deposition of amyloid material that is detected with Congo red staining and is difficult to diagnose. Involvement of the tracheobronchial tree is rare and is a challenge for pulmonologists because of the wide differential diagnosis of this disease. We present two cases where tracheobronchial affectation has been observed: in one of them as a primary disease, and in another as secondary affectation. The use of bronchoscopic techniques is essential for the diagnosis of tracheobronchial involvement. In the absence of an effective drug therapy, local management of this disease with endoscopic techniques for bronchial repermeabilization is able to provide clinical improvement and expand the treatment options and prognosis in this disease.
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