J Korean Med Sci.  2005 Jun;20(3):524-527. 10.3346/jkms.2005.20.3.524.

A Case of Femoral Compressive Neuropathy in AL Amyloidosis

• Kang EH
• Lee EB
• Im CH
• Kim JH
• Park JJ
• Lee JC
• Kim SH
• Song YW

• KMID: 1778521
• DOI: http://doi.org/10.3346/jkms.2005.20.3.524

Abstract

We describe a case of a 54-yr-old AL amyloidosis patient who developed femoral compressive neuropathy due to iliopsoas pseudohypertrophy. The patient, who presented with end stage renal disease, was referred to our clinic because of lower extremity weakness and polyarthritis. Finally, he was diagnosed as having kappa-AL amyloidosis, complicated by femoral compressive neuropathy, hypertrophic amyloid myopathy, amyloid arthropathy, carpal tunnel syndrome, and end stage renal disease. Femoral compressive neuropathy has never been reported in association with amyloid induced iliopsoas hypertrophic myopathy. This report expands the clinical spectrum of AL amyloidosis.

Keyword

Amyloidosis; Muscle Weakness; Femoral Neuropathy

MeSH Terms

Amyloidosis/*pathology
Fatal Outcome
Femoral Neuropathy/*pathology
Humans
Hypertrophy
Kidney Failure, Chronic/pathology
Male
Middle Aged
Nerve Compression Syndromes/*pathology
Psoas Muscles/pathology

Figure

• 

  Fig. 1 Immunofluorescent staining of the shoulder pad biopsy shows diffuse, strong deposits of kappa light chains (×200).

• 

  Fig. 2 Pelvis MRI. Enhanced T1-weighted (A) and T2-weighted (B) images, demonstrating pseudohypertrophied iliopsoas muscles (arrow heads) compressing femoral nerves (arrows).

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  Fig. 3 Endomysial and perimysial deposition of amyloid in the iliopsoas muscle. Congo red with light microscopy (A) and with polarizing microscopy (B) (×100).

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