Cardiac and renal amyloidosis revealing multiple myeloma

A 55-year-old patient gradually developed congestive heart failure with a l ow-voltage electrocardiogram exhibiting necrosis-like alterations, Doppler echocardiography demonstrated hypertrophy of the ventricular walls and sept um with a hyperechoic granular and sparkling appearance. In addition to thi s restrictive cardiomyopathy suggestive of cardiac amyloidosis, the patient had chronic renal failure. An IgG myeloma was found. Rectal and gingival b iopsies were negative for amyloid, However, the outcome was fatal and the p ostmortem examination demonstrated AL amyloid in the heart.