Systemic Light Chain Amyloidosis Mimicking Rheumatic Disorders

Abstract

Secondary amyloidosis can complicate chronic inflammatory autoimmune diseases. However, the clinical findings of primary amyloidosis may mimic those of primary rheumatologic disorders. We present the case of a 53-year-old woman who presented with dystrophic nail changes, dry eyes, bilateral carpal tunnel syndrome, Raynaud's phenomenon, and high titer positive nucleolar pattern antinuclear antibody. She was initially misdiagnosed as having Undifferentiated Connective Tissue Disease (UCTD). On further workup, she was eventually diagnosed with lambda light chain systemic amyloidosis by abdominal fat pad biopsy. Her symptoms completely resolved after autologous stem cell transplantation. With this case, we would like to highlight the similarities in the clinical features between light chain amyloidosis and rheumatological disorders. We would also like to emphasize the importance of the prompt recognition of the clinical features of amyloidosis which are crucial to triggering appropriate diagnostic procedures, since early diagnosis is a key to improving outcomes in this disease with an otherwise poor prognosis.

Nail Amyloidoma: Two Case Reports of a New Entity

“…Nail changes in the context of systemic AL amyloidosis are uncommon, but they can be the first and unique sign of this systemic disease [6]. These include nail brittleness, trachyonychia, longitudinal ridging, onycholysis, subungual thickening, and subungual splinter hemorrhages, and the main clinical differential diagnosis is lichen pla-nus [6,10]. Nail biopsy may show amyloid deposits in the papillary dermis of the matrix, the nail bed, or nail folds [10,11].…”

Clinical Masks of Amyloidosis With the Heart Involvement: Modern Diagnostic Issues

“…Описаны случаи обнаружения вирусного генома в миокарде у больных с амилоидозом [21]. Имеются данные о появлении стандартного АНФ при AL-амилоидозе [22] (выявлен у нашей больной К. ), однако уровень антикардиальных антител у этих больных не изучался.…”

Type 2 Diabetes Mellitus: a reciprocal mutual interaction with amyloidosis or a presentation of an isolated primary pancreatic amyloidosis?

“…Meanwhile, secondary amyloidosis has been shown to complicate chronic inflammatory autoimmune diseases [4] and chronic diseases such as autoimmune disease and T2DM have also been suggested to be potential factors for AA amyloidosis [5]. Thus, a reciprocal interaction may be also involved; several cases of insulin-derived localized amyloidosis have been reported like those mentioned in [6,7] and a case of primary systemic amyloidosis with the history of T2DM for nine years has also been recently described [8].…”