No abstract

Amyloid arthropathy can mimic inflammatory rheumatism and is often underdiagnosed. The presence of macroglossia should draw attention to chronic polyarthritis. We report a case of AL amyloidosis complicating multiple myeloma in a 50-year-old man with chronic peripheral polyarthralgia and macroglossia.AL amyloidosis is related to extracellular deposition of free light chains (more rarely heavy chains) of monoclonal immunoglobulins produced by a lymphoplasmacytic population. It is secondary to multiple myeloma (MM) in 5%-15% of cases and often underdiagnosed due to its polymorphic presentation. 1 The arthropathy secondary to amyloid depositions remains rare with a prevalence of 3% according to studies. 2 We report a case of AL amyloidosis complicating MM revealed by bilateral peripheral polyarthritis associated with macroglossia. | OBSERVATIONA 50-year-old man had come for consultation for hands and wrists bilateral joint pain that had been evolving since 2 years, affecting the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, sometimes waking him up at night, not calmed at rest, with gradual increase in intensity. These symptoms occurred in a context of asthenia, anorexia, and weight loss. In his history, he reported repeated episodes of infectious lung disease.The clinical examination at admission revealed a reducible deformation of the hands such as cubital gale of the fingers and flexion of the MCP and PIP (Figure 1A). There was no joint swelling or skin nodule in relation to the joints. The examination also found a painless macroglossia with indentations of the lateral edges (Figure 1B). This macroglossia was responsible for moderate dysphagia.

A 75-year-old man with an aortic bioprosthesis was admitted with polyarthritis in a non-febrile setting. Blood cultures were positive for Listeria monocytogenes. The diagnosis of Listeria endocarditis and spondylodiscitis was evoked. These are two unusual forms of listeriosis.The evolution was favourable after antibiotic therapy.

A 75‐year‐old man with an aortic bioprosthesis was admitted with polyarthritis in a non‐febrile setting. Blood cultures were positive for Listeria monocytogenes. The diagnosis of Listeria endocarditis and spondylodiscitis was evoked. These are two unusual forms of listeriosis. The evolution was favorable after antibiotic therapy.

We report a 24‐year‐old female patient not infected with human immunodeficiency virus (HIV) and without other risk factors of immunosuppression, presenting with neuromeningeal cryptococcosis. Cerebrospinal fluid (CSF) analysis revealed the presence of Cryptococcus neoformans. The evolution was unfavorable and the patient died even after appropriate antifungal treatment.