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CASE 5

CASE 5. Dr Amanjit Bal, PGIMER, Chandigarh. 55F Presented with rapidly progressive anasarca Associated symptoms included generalized weakness and exertional breathlessness Total Serum Proteins: 2.8gm, Albumin: 0.98gm 24hr urine protein: 1.3 gm

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CASE 5

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  1. CASE 5 Dr Amanjit Bal, PGIMER, Chandigarh

  2. 55F Presented with rapidly progressive anasarca Associated symptoms included generalized weakness and exertional breathlessness Total Serum Proteins: 2.8gm, Albumin: 0.98gm 24hr urine protein: 1.3 gm Urine BJP: -ve, Serum/urine electrophoresis: no “M” band. CXR: Bilateral pleural effusion USG Abdomen: RK 9.9 cm; LK 10.2 cm; B/L moderate pl. effusion; pericardial effusion & ascites. Compression USG: No evidence of DVT in both LL. Extreme subcutaneous edema noted. ECG: low voltage complexes 2D Echo: Concentric LVH (+); LV diastolic dysfunction, no RWMA, no effusion/clot/vegetation; EF: 80%

  3. PAS Congo Red

  4. PM 22146

  5. Positive control AA PM 22146

  6. Positive control Kappa light chain PM 22146

  7. Positive control Lamda light chain PM 22146

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