• Internal medicine · Jun 2024

    Case Reports

    A Gluteus Medius Muscle Biopsy to Confirm Amyloid Transthyretin Deposition in Wild-type Transthyretin Cardiac Amyloidosis: A Report of Two Cases.

    • Koji Takahashi, Takaaki Iwamura, Yoshiyasu Hiratsuka, Daisuke Sasaki, Nobuhisa Yamamura, Mitsuharu Ueda, Hiroe Morioka, Mako Yoshino, Daijiro Enomoto, Shigeki Uemura, Takafumi Okura, Tomoki Sakaue, and Shuntaro Ikeda.
    • Department of Community Emergency Medicine, Ehime University Graduate School of Medicine, Japan.
    • Intern. Med. 2024 Jun 1; 63 (11): 157515841575-1584.

    AbstractIn patients with wild-type transthyretin cardiac amyloidosis (ATTRwt-CA), the uptake of the tracer on technetium-99m-labeled pyrophosphate (99mTc-PYP) scintigraphy, which indicates amyloid transthyretin (ATTR) per se, is often observed in skeletal muscles, such as the abdominal oblique and gluteal muscles. Among extracardiac biopsies for confirming ATTR deposition in ATTRwt-CA, a 99mTc-PYP imaging-based computed tomography (CT)-guided core needle biopsy of the internal oblique muscle has relatively high sensitivity. In some patients, the 99mTc-PYP uptake is more pronounced in the gluteal muscles than in oblique muscles. We herein report two cases of ATTRwt-CA in which a CT-guided biopsy of the gluteus medius muscle with 99mTc-PYP uptake confirmed the presence of ATTR deposits.

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