Hydroxychloroquine-Mediated Cardiotoxicity With a False-Positive 99mTechnetium–Labeled Pyrophosphate Scan for Transthyretin-Related Cardiac Amyloidosis
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- glomerular filtration rate
- Sjogren’s syndrome
- tomography, emission-computed, single-photon
Cardiac amyloidosis is a rare infiltrative process most commonly caused by abnormal deposition of precursor proteins from monoclonal light chain or transthyretin (ATTR).1 An accurate diagnosis of the amyloidosis subtype has crucial prognostic and therapeutic implications. Bone scintigraphy using 99mtechnetium-labeled pyrophosphate (99mTc-PYP) has been found to have a sensitivity and specificity of 68% and 100%, respectively, for ATTR in patients without evidence of plasma cell dyscrasia.2 Furthermore, high heart/contralateral ratio of ≥1.6 predicted worse survival.3 This has led to a proposed nonbiopsy diagnosis of ATTR using bone scintigraphy.2 However, without widely using 99mTc-PYP scan in various cardiac conditions, the true specificity for …