Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.
Soumya Ramireddy
Soumya.Ramireddy@bmc.org
Amyloidosis Center, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118

Main Body of the Abstract
Advances in fibril typing by LCMS/MS have improved the accuracy of amyloidosis diagnosis, revealing instances of dual amyloidogenic proteins within the same individual. However, reports of two different amyloidogenic proteins affecting the same organ are scarce in the literature.
We present a retrospective analysis of six cases of dual amyloidosis diagnosed at our center between 1995 and 2022. Diagnosis was confirmed through Congo red staining and fibril typing using the best available methods at the time. All cases underwent TTR gene testing.
Of the six cases, three (50%) exhibited AL amyloidosis alongside underlying B-cell lymphoproliferative disorders in conjunction with ATTRwt amyloidosis. Notably, one case demonstrated dual amyloidosis in a single endomyocardial biopsy, with clinical features indicative of ATTRwt-driven cardiomyopathy. Two additional cases were diagnosed with AL/ATTRwt and AA/ATTRwt amyloidoses, respectively, while one case presented with AIns and ATTRv amyloidoses. The time interval between the two diagnoses ranged from 1 to 24 years, with the heart and kidneys being the most commonly affected organs.
Our findings underscore the complexity of amyloidosis presentation, with multiple amyloid types potentially coexisting in an individual, either in the same or different anatomical sites. Accurate assessment of clinical phenotype and thorough amyloid fibril typing from various organs are essential for precise diagnosis and tailored treatment strategies.

**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Soumya Ramireddy
Soumya.Ramireddy@bmc.org
Amyloidosis Center, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118

**Main Body of the Abstract**
Advances in fibril typing by LCMS/MS have improved the accuracy of amyloidosis diagnosis, revealing instances of dual amyloidogenic proteins within the same individual. However, reports of two different amyloidogenic proteins affecting the same organ are scarce in the literature.
We present a retrospective analysis of six cases of dual amyloidosis diagnosed at our center between 1995 and 2022. Diagnosis was confirmed through Congo red staining and fibril typing using the best available methods at the time. All cases underwent TTR gene testing.
Of the six cases, three (50%) exhibited AL amyloidosis alongside underlying B-cell lymphoproliferative disorders in conjunction with ATTRwt amyloidosis. Notably, one case demonstrated dual amyloidosis in a single endomyocardial biopsy, with clinical features indicative of ATTRwt-driven cardiomyopathy. Two additional cases were diagnosed with AL/ATTRwt and AA/ATTRwt amyloidoses, respectively, while one case presented with AIns and ATTRv amyloidoses. The time interval between the two diagnoses ranged from 1 to 24 years, with the heart and kidneys being the most commonly affected organs.
Our findings underscore the complexity of amyloidosis presentation, with multiple amyloid types potentially coexisting in an individual, either in the same or different anatomical sites. Accurate assessment of clinical phenotype and thorough amyloid fibril typing from various organs are essential for precise diagnosis and tailored treatment strategies.

The Amyloidosis Intersection: Exploring Dual Types in a Single Host PC15 (#189)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.