ArticleJACC. Case reports2026
AL Cardiac Amyloidosis Presenting as Grade 3 ATTR Mimicry on Scintigraphy.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGrade 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). DISCUSSION: Grade 3 uptake in AL is a rare diagnostic "false flag" signifying heavy infiltration. Hematologic evaluation is mandatory in patients with positive uptake to avoid misclassification. TAKE-HOME MESSAGES: Grade 3 uptake in AL is an infrequent finding indicating advanced myocardial infiltration and poor prognosis. Hematologic screening is mandatory before interpreting scintigraphy to prevent misclassifying severe AL as transthyretin amyloidosis.
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