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Eur J Cardiothorac Surg 2001;20:871-873
© 2001 Elsevier Science NL

Case report

Vascular amyloidosis causing spontaneous mediastinal haemorrhage with haemothorax

^a Department of Thoracic Surgery, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK
^b Department of Pathology, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK

Received 22 May 2001; received in revised form 3 July 2001; accepted 5 July 2001.

Corresponding author. Tel.: +44-115-969-1169; fax: +44-115-962-7730
e-mail: dbeggs{at}ncht.org.uk

Bleeding diathesis is a recognised complication of amyloid disease. Localised and generalised bleeding manifestations are usually associated with intravascular coagulopathy related to isolated or multiple coagulation factor deficiencies. Recently, there have been reports of haemorrhage due to amyloid deposition in blood vessel walls and in the perivascular region leading to increased fragility and poor haemostasis. We report a case of spontaneous mediastinal haemorrhage due to amyloid involvement of vascular tissue in the absence of coagulopathy.

Key Words: Amyloidosis • Haemorrhage • Bleeding diathesis

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