| Abstract text: |
A 62 – year woman with heart history, with a lot of cardiovascular risk factors (cardiovascular heredity, hypertension for 10 years with treatment, dyslipidemia, type 2 diabetes, obesity) who has been in hospital for one month ago, with an altered general mood, long lasting mild anemia 11,3 g% and more than 114 mm/1h erythrocyte sediment velocity, without a specific diagnosis (possible system disease), had two month ago an retrosternal pain with dry cough, dyspnea and palpitations and a lumbar pain followed up by left sciatic irradiation. The ischemia and arrhythmias was excluded – ECG and cardiac enzymes were normal. After the first clinical cardiological, neurological, ORL and laboratory evaluation (mild anemia 11,3g% and erythrocyte sediment velocity 93/134 mm/1-2 h the diagnosis was Helicobacter pylori infection (past or recent) and urinary infection. After specific antibiotic treatment for both infections the erythrocyte sediment velocity was 98/135 mm/1-2h and immune-electrophoresis reveals an monoclonal immunoglobulin lambda type. The patient is sent to Hematology for medullar puncture and immunosuppressive therapy and the prognosis depends on the basic disease. The case is particular by the unexpected discovery of a monoclonal gamapathy to a patient with cardiovascular disease which presented an retrosternal pain with dry cough and pulmonary normal X ray. |
