Abstract
TYPE: Case Report TOPIC: Cardiovascular Disease INTRODUCTION: A wild-type ATTR amyloidosis is a systemic disease with multi-organ dysfunction, involving heart, kidney, skin, and gastrointestinal tract, due to deposition of wild-type transthyretin in each organ. CASE PRESENTATION: We had a 76-year-old man diagnosed with wild-type ATTR cardiac amyloidosis, whose heart failure symptom improved by anti-heart failure medications but constipation refractory to multiple conventional medications persisted. Following the conversion from lubiprostone to Kampo medicine mashiningan, his average days per one evacuation decreased from around 7.0 days down to 1.6 days. DISCUSSION: Amyloid-related gastrointestinal comorbidities are often refractory to the conventional medications. Mashiningan might increase the proportion of soft feces via increasing intestinal fluid secretion through cystic fibrosis transmembrane conductance regulator chloride channel activation. CONCLUSIONS: Mashininigan might be alternative option to improve refractory constipation in patients with cardiac amyloidosis. DISCLOSURE: Nothing to declare. KEYWORD: heart failure
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