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UPCOMING SESSIONS in ET
Wed, Apr 29, 2026 · 10:00 – 11:00 PM UTC
ATTR-CM how do I know my treatment is working?
Rebecca Hung MD
Click To Register
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AL Cardiac Amyloidosis Presenting as Grade 3 ATTR Mimicry on Scintigraphy

Published: Jan 23, 2026
Category
Researchers
Key Information
Source
JACC Journals
Year
2026
summary/abstract

Abstract

Background

Grade 2 or 3 uptake on 99mTc-pyrophosphate scintigraphy is a cornerstone for diagnosing transthyretin amyloidosis. However, light-chain amyloidosis can infrequently mimic this pattern, causing diagnostic error.

Case Summary

A 53-year-old man with heart failure presented with left ventricular hypertrophy and elevated biomarkers. Cardiac magnetic resonance suggested infiltration. 99mTc-pyrophosphate scintigraphy showed intense grade 3 (Perugini) uptake. However, immunofixation revealed an immunoglobulin G lambda clone. Fat and duodenal biopsies confirmed systemic light-chain amyloidosis (AL).
Authors
Kevin Zambrano Zambrano , Julio Martínez Salazar, Jason Cedric Velarde Michaud, Brian de Jesús Bernal Alferes, Emmanuel Ortega Martínez, Carlos Emiliano Fernández Sánchez, Luis Montiel López, and Alexis Zambrano Zambrano