**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.**
Ellen Lewis, Tom Baker Cancer Center, Calgary, Alberta, Canada

**Main Body of the Abstract**
Background: Given amyloidosis can be a multi-system disease, the workup brings challenges especially for patients with multiple co-morbidities. We present a case of localized iatrogenic amyloidosis in a patient with features commonly associated with systemic amyloidosis.
Case Report: A 70-year-old male with progressive dyspnea, cardiomyopathy, and monoclonal gammopathy presented to clinic for workup. Past medical history included carpel tunnel syndrome, coronary artery disease, chronic kidney disease, and obesity (previously on liraglutide). Workup showed IgA kappa monoclonal protein, elevated kappa light-chains (108.8g/l), and an NTProBNP 843 ug/ml. Cardiac MRI showed LVEF 27%, multiple sessile thrombi, with normal T1/T2 mapping. BMA showed 5-10% kappa-restricted plasmacytosis suggestive of smoldering myeloma, congo-red negative. Fat pad biopsy detected amyloid deposition however, mass spectrometry could not determine a sub-type. Immunohistochemistry was performed showing negative to insulin and positive to glucagon. Given the homology between liraglutide and glucagon, inability to detect additional amyloid sub-type, and patient's history, a diagnosis of GLP-1 amyloidosis was made. PYP scan done 3- months post-diagnosis was not suggestive of ATTR amyloidosis. The patient was optimized by cardiology for the thrombi discovered on MRI. He remains off liraglutide indefinity.
Conclusion: The was the first case of GLP-1 amyloidosis described in Canada. Given his history and comorbidities it would be easy to assume the underlying pathology was systemic amyloidosis (1), highlighting the importance of sub-typing. This case raises caution as the use of GLP-1 agonists for weight loss has risen steadily in the developing world.(2)



**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.**
Ellen Lewis, Tom Baker Cancer Center, Calgary, Alberta, Canada

**Main Body of the Abstract**
**Background:** Given amyloidosis can be a multi-system disease, the workup brings challenges especially for patients with multiple co-morbidities. We present a case of localized iatrogenic amyloidosis in a patient with features commonly associated with systemic amyloidosis.
**Case Report:** A 70-year-old male with progressive dyspnea, cardiomyopathy, and monoclonal gammopathy presented to clinic for workup. Past medical history included carpel tunnel syndrome, coronary artery disease, chronic kidney disease, and obesity (previously on liraglutide). Workup showed IgA kappa monoclonal protein, elevated kappa light-chains (108.8g/l), and an NTProBNP 843 ug/ml. Cardiac MRI showed LVEF 27%, multiple sessile thrombi, with normal T1/T2 mapping. BMA showed 5-10% kappa-restricted plasmacytosis suggestive of smoldering myeloma, congo-red negative. Fat pad biopsy detected amyloid deposition however, mass spectrometry could not determine a sub-type. Immunohistochemistry was performed showing negative to insulin and positive to glucagon. Given the homology between liraglutide and glucagon, inability to detect additional amyloid sub-type, and patient's history, a diagnosis of GLP-1 amyloidosis was made. PYP scan done 3- months post-diagnosis was not suggestive of ATTR amyloidosis. The patient was optimized by cardiology for the thrombi discovered on MRI. He remains off liraglutide indefinity.
**Conclusion:** The was the first case of GLP-1 amyloidosis described in Canada. Given his history and comorbidities it would be easy to assume the underlying pathology was systemic amyloidosis (1), highlighting the importance of sub-typing. This case raises caution as the use of GLP-1 agonists for weight loss has risen steadily in the developing world.(2)



Case Report of GLP-1 Amyloidosis: The Importance of Amyloid Typing PC20 (#425)

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.