SARCOID, AMYLOID, AND ACUTE MYOCARDIAL FAILURE

We report the case of a 58-year-old woman, with an 8-year history of p ulmonary sarcoidosis, who died in acute myocardial failure after cardi ac catheterization, Systemic amyloid, Likely of the AL type, was found to involve her myocardial interstitium and intramyocardial coronary a rteries, as well as her spleen, thyroid, kidneys, and bone marrow. Her acute myocardial failure was thought to be the result of focal myocar dial infarcts secondary to amyloid vasculopathy and of superimposed ch ronic restrictive myocardial function caused by amyloid, Five precious ly reported cases of concurrent sarcoidosis and AA-type amyloid remind us that there is significant experimental data implicating the inflam matory process of sarcoidosis in the causation of AA-type amyloidosis, The concurrence of sarcoidosis and AL-type systemic amyloid seen in t his patient was reported in the literature once before, and we think t he concurrence was a coincidence.