Clin Osteol 2025; 30(3): 167-171

A case study: Diagnostic relation of Paget's disease and cardiac transthyretin amyloidosisCase reports

Filip Lukačík1, Vladimíra Baarová2, Klára Mátlová3, Richard Pikner3
1 Lékařská fakulta v Plzni, Univerzita Karlova v Praze
2 Oddělení nukleární medicíny, Klatovská nemocnice, a. s.
3 Oddělení klinických laboratoří a kostního metabolizmu, Klatovská nemocnice, a. s.

Paget´s disease of bone is a metabolic bone disorder characterised by excessive bone resorption followed by an increase in bone formation of defective bone. Diagnosis is based on laboratory findings of elevated ALP, X­ray and whole body bone scintigraphy. Transthyretin amyloidosis (ATTR) of heart is a storage disease characterised by pathological deposition of transthyretin protein. Specific scintigraphic examination using 99mTc DPD is necessary to confirm ATTR or an endocardial biopsy if needed. Excessive accumulation of bone­seeking radiopharmaceuticals in the myocardium may occur during the whole body bone scintigraphy. This accumulation may point out to ATTR presence. We present a case report of a patient in whom the diagnosis of Paget's disease led to a concurrent diagnosis of ATTR. ATTR was diagnosed based on clinical manifestations of heart failure and the finding of radiopharmaceutical accumulation in the myocardium during whole-body bone scintigraphy using 99mTc HDP.

Keywords: bone scintigraphy, Paget's disease, transthyretin amyloidosis.

Published: September 1, 2025  Show citation

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Lukačík F, Baarová V, Mátlová K, Pikner R. A case study: Diagnostic relation of Paget's disease and cardiac transthyretin amyloidosis. Clinical Osteology. 2025;30(3):167-171.
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