NYMC Faculty Publications

A Case of Disappearing Amyloid on Technetium Pyrophosphate Scan

Author Type(s)

Resident/Fellow, Faculty

DOI

10.1007/s12350-023-03316-1

Journal Title

Journal of Nuclear Cardiology

First Page

1986

Last Page

1991

Document Type

Article

Publication Date

10-1-2023

Department

Pathology, Microbiology and Immunology

Second Department

Medicine

Abstract

Technetium-99mm pyrophosphate (Tc-PYP) scintigraphy is a highly accurate non-invasive method for the diagnosis of transthyretin (ATTR) cardiac amyloidosis. Prognosis for this disease is improved following treatment with the transthyretin (TTR) stabilizer tafamidis. Although tafamidis slows disease progression, its effects on myocardial amyloid and Tc-PYP uptake remain unclear. We present a patient with ATTR cardiac amyloidosis who had a strongly positive initial Tc-PYP scan, with a dramatic decrease in Tc-PYP uptake on repeat scan after 3 years of tafamidis treatment. However, myocardial biopsy showed persistent diffuse amyloid deposits. This case highlights the need for further studies regarding the utility of serial Tc-PYP scans in monitoring the progress of ATTR cardiomyopathy.

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