{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679026084864.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.11281/shinzo.48.428"}},{"identifier":{"@type":"NAID","@value":"130006745897"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2016239446"}}],"dc:title":[{"@language":"ja","@value":"繰り返す失神を契機に診断されたAL心アミロイドーシスの1例"},{"@language":"en","@value":"A case of AL cardiac amyloidosis with recurrent syncope"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"ja","@value":"<p> 症例は77歳の男性. 生来健康であったが, 当院入院の数カ月前から, 失神を繰り返しており他院で精査されたが原因不明であった. また, 同時期頃より下肢のしびれや嗄声も認めていた. 当院で施行した心臓超音波検査で, 軽度の左室肥大と心嚢液貯留を認め, 二次性心筋症を疑い心臓カテーテル検査を施行した. 冠動脈に有意狭窄は認めなかったものの, 心筋生検で免疫グロブリン軽鎖 (immunoglobulin light chain ; IGLC) κ型のアミロイド沈着を認めた. また, 尿中Bence Jones蛋白 (Bence Jones Protein ; BJP) が陽性のため骨髄生検を施行したところ, 多発性骨髄腫 (BJPκ型) の診断に至り, 本症例は骨髄腫に伴うALアミロイドーシスと考えられた. 化学療法により多発性骨髄腫の病勢コントロールは良好であったが, 経過中に失神を伴う薬剤抵抗性の心室頻拍が出現したため植込み型除細動器を挿入した. 心アミロイドーシスは, 心筋にアミロイド蛋白が沈着することで不可逆性の心筋障害をきたし, 心不全や不整脈などの多彩な臨床症状をもたらす. アミロイドーシスに心臓病変を合併した場合は予後不良であるため, 早期診断・早期治療が重要である. 本症例のように, 特に既往のない心肥大は心アミロイドーシス含め二次性心筋症の可能性を考慮する必要がある.</p>"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410282679026084872","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376671"}],"foaf:name":[{"@language":"ja","@value":"永井 泰斗"},{"@language":"en","@value":"Nagai Taito"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084868","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376675"}],"foaf:name":[{"@language":"ja","@value":"榎本 善成"},{"@language":"en","@value":"Enomoto Yoshinari"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084870","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376676"}],"foaf:name":[{"@language":"ja","@value":"伊藤 雄太"},{"@language":"en","@value":"Ito Yuta"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084865","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376677"}],"foaf:name":[{"@language":"ja","@value":"長島 義宜"},{"@language":"en","@value":"Nagashima Yoshinori"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084738","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376678"}],"foaf:name":[{"@language":"ja","@value":"飯島 雷輔"},{"@language":"en","@value":"Iijima Raisuke"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001204671123459","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000240094654"},{"@type":"NRID","@value":"9000020879674"},{"@type":"NRID","@value":"9000367429745"},{"@type":"NRID","@value":"9000413779887"},{"@type":"NRID","@value":"9000405641064"},{"@type":"NRID","@value":"9000398030245"},{"@type":"NRID","@value":"9000287355653"},{"@type":"NRID","@value":"9000411003285"},{"@type":"NRID","@value":"9000021308278"},{"@type":"NRID","@value":"9000021164579"},{"@type":"NRID","@value":"9000321626650"},{"@type":"NRID","@value":"9000257904963"},{"@type":"NRID","@value":"9000241819311"},{"@type":"NRID","@value":"9000257179237"},{"@type":"NRID","@value":"9000018697614"},{"@type":"NRID","@value":"9000412316178"},{"@type":"NRID","@value":"9000403052474"},{"@type":"NRID","@value":"9000019105268"},{"@type":"NRID","@value":"9000316692606"},{"@type":"NRID","@value":"9000345219035"},{"@type":"NRID","@value":"9000242139418"},{"@type":"NRID","@value":"9000398175430"},{"@type":"NRID","@value":"9000022062505"},{"@type":"NRID","@value":"9000391376679"},{"@type":"NRID","@value":"9000397424342"},{"@type":"NRID","@value":"9000405115414"},{"@type":"NRID","@value":"9000398449894"},{"@type":"NRID","@value":"9000386336203"},{"@type":"NRID","@value":"9000261658205"},{"@type":"NRID","@value":"9000283687544"},{"@type":"KAKEN_RESEARCHERS","@value":"80385848"},{"@type":"NRID","@value":"1000080385848"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/harahide"}],"foaf:name":[{"@language":"ja","@value":"原 英彦"},{"@language":"en","@value":"Hara Hidehiko"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084737","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376680"}],"foaf:name":[{"@language":"ja","@value":"野呂 眞人"},{"@language":"en","@value":"Noro Mahito"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1420564276161483008","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"30256721"},{"@type":"NRID","@value":"1000030256721"},{"@type":"NRID","@value":"9000003870322"},{"@type":"NRID","@value":"9000240094653"},{"@type":"NRID","@value":"9000003986769"},{"@type":"NRID","@value":"9000021166684"},{"@type":"NRID","@value":"9000021261508"},{"@type":"NRID","@value":"9000020879694"},{"@type":"NRID","@value":"9000367429746"},{"@type":"NRID","@value":"9000413779885"},{"@type":"NRID","@value":"9000242092348"},{"@type":"NRID","@value":"9000283560729"},{"@type":"NRID","@value":"9000256871866"},{"@type":"NRID","@value":"9000257810763"},{"@type":"NRID","@value":"9000001859629"},{"@type":"NRID","@value":"9000004097437"},{"@type":"NRID","@value":"9000413502517"},{"@type":"NRID","@value":"9000021331244"},{"@type":"NRID","@value":"9000412213341"},{"@type":"NRID","@value":"9000397944468"},{"@type":"NRID","@value":"9000262366296"},{"@type":"NRID","@value":"9000004302574"},{"@type":"NRID","@value":"9000006144985"},{"@type":"NRID","@value":"9000377395044"},{"@type":"NRID","@value":"9000405890661"},{"@type":"NRID","@value":"9000283128678"},{"@type":"NRID","@value":"9000275825415"},{"@type":"NRID","@value":"9000414376302"},{"@type":"NRID","@value":"9000283130276"},{"@type":"NRID","@value":"9000256880586"},{"@type":"NRID","@value":"9000021308312"},{"@type":"NRID","@value":"9000411630595"},{"@type":"NRID","@value":"9000255952989"},{"@type":"NRID","@value":"9000256882158"},{"@type":"NRID","@value":"9000405890586"},{"@type":"NRID","@value":"9000303163021"},{"@type":"NRID","@value":"9000241773583"},{"@type":"NRID","@value":"9000240094923"},{"@type":"NRID","@value":"9000021288945"},{"@type":"NRID","@value":"9000021353723"},{"@type":"NRID","@value":"9000272989899"},{"@type":"NRID","@value":"9000021383716"},{"@type":"NRID","@value":"9000021794752"},{"@type":"NRID","@value":"9000021683907"},{"@type":"NRID","@value":"9000391376681"},{"@type":"NRID","@value":"9000243898758"},{"@type":"NRID","@value":"9000415045980"},{"@type":"NRID","@value":"9000256880805"},{"@type":"NRID","@value":"9000257812728"},{"@type":"NRID","@value":"9000020116407"},{"@type":"NRID","@value":"9000386336194"},{"@type":"NRID","@value":"9000413526668"},{"@type":"NRID","@value":"9000021182714"},{"@type":"NRID","@value":"9000403564697"},{"@type":"NRID","@value":"9000283225878"},{"@type":"NRID","@value":"9000240094515"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/read0044589"}],"foaf:name":[{"@language":"ja","@value":"諸井 雅男"},{"@language":"en","@value":"Moroi Masao"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084864","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376682"}],"foaf:name":[{"@language":"ja","@value":"鈴木 真事"},{"@language":"en","@value":"Suzuki Makoto"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084867","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376672"}],"foaf:name":[{"@language":"ja","@value":"中村 正人"},{"@language":"en","@value":"Nakamura Masato"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084736","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376673"}],"foaf:name":[{"@language":"ja","@value":"杉 薫"},{"@language":"en","@value":"Sugi Kaoru"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiovascular Medicine, Toho University Ohashi Medical Center"},{"@language":"ja","@value":"東邦大学医療センター大橋病院 循環器内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679026084871","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000391376674"}],"foaf:name":[{"@language":"ja","@value":"鈴木 謙"},{"@language":"en","@value":"Suzuki Ken"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Depertment of Hematology, Toshiba Hospital"},{"@language":"ja","@value":"東芝病院 血液内科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"05864488"},{"@type":"LISSN","@value":"05864488"},{"@type":"EISSN","@value":"21863016"}],"prism:publicationName":[{"@language":"en","@value":"Shinzo"},{"@language":"ja","@value":"心臓"},{"@language":"en","@value":"Shinzo"},{"@language":"ja","@value":"心臓"}],"dc:publisher":[{"@language":"en","@value":"Japan Heart Foundation"},{"@language":"ja","@value":"公益財団法人 日本心臓財団"}],"prism:publicationDate":"2016","prism:volume":"48","prism:number":"4","prism:startingPage":"428","prism:endingPage":"433"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2016239446"}],"availableAt":"2016","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E5%BF%83%E3%82%A2%E3%83%9F%E3%83%AD%E3%82%A4%E3%83%89%E3%83%BC%E3%82%B7%E3%82%B9","dc:title":"心アミロイドーシス"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%A4%B1%E7%A5%9E","dc:title":"失神"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%BF%83%E5%AE%A4%E9%A0%BB%E6%8B%8D","dc:title":"心室頻拍"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%88%BF%E5%AE%A4%E3%83%96%E3%83%AD%E3%83%83%E3%82%AF","dc:title":"房室ブロック"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2002144043"},{"@type":"CIA","@value":"130006745897"}]}