Korean J Clin Neurophysiol.  2015 Jun;17(1):24-27. 10.14253/kjcn.2015.17.1.24.

Myeloma-associated Amyloidosis Presenting as Orthostatic Intolerance

• Jeong H
• Nam W
• Son S
• Kim SK
• Kang H
• Choi NC
• Kwon OY
• Lim B
• Park KJ

• KMID: 2225216
• DOI: http://doi.org/10.14253/kjcn.2015.17.1.24

Abstract

Amyloidosis is a systemic disorder associated with clonal plasma cell dyscrasia. Nephrotic syndrome, congestive heart failure, autonomic and peripheral neuropathy is often associated features in amyloidosis. Early diagnosis is most important because of different prognosis by stage. The diagnosis can be delayed since symptoms of amyloidosis may vary or nonspecific. We describe a patient of myeloma-associated amyloidosis, who showed orthostatic intolerance as the first symptom of the disease.

Keyword

Orthostatic intolerance; Amyloidosis; Neuropathy

MeSH Terms

Amyloidosis*
Diagnosis
Early Diagnosis
Heart Failure
Humans
Nephrotic Syndrome
Orthostatic Intolerance*
Paraproteinemias
Peripheral Nervous System Diseases
Prognosis

Figure

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  Fig. 1. (A) Head-up tilt table test shows marked orthostatic hypotension. (B) Quantitative sudomotor axon reflex test (QSART) shows global postganglionic sudomotor dysfunction.

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  Fig. 2. Duodenal mucosa biopsy finding with Congo-red staining shows amyloid positive (A), apple-green birefringence under polarized light microscope (B) (Congo-red stain, ×40).

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