Macroglossia, the first manifestation of systemic amyloidosis associated with multiple myeloma: Case report

Maturana-Ramírez, Andrea; Ortega, Ana Verónica; Labbé, F.C.; Moraes, Êmile de; Aitken-Saavedra, J.P.

doi:10.1016/j.jormas.2018.06.009

Cited by 13 publications

(16 citation statements)

References 11 publications

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“…Renal signs and symptoms are considered rather classic for multiple myeloma; however, the prototypical hypercalcemia and acute kidney injury are not the only harbingers of disease. Maturana-Ramírez et al described the case of a 73-year-old female who initially presented with weight loss and macroglossia, initially diagnosed with amyloidosis of the tongue [33]. Further medical evaluation revealed hypercalcemia, hyperphosphatemia, and endstage renal disease requiring emergent hemodialysis, with the final diagnosis being systemic amyloidosis with multiple myeloma [33].…”

Section: Renal Diseasementioning

confidence: 99%

“…Maturana-Ramírez et al described the case of a 73-year-old female who initially presented with weight loss and macroglossia, initially diagnosed with amyloidosis of the tongue [33]. Further medical evaluation revealed hypercalcemia, hyperphosphatemia, and endstage renal disease requiring emergent hemodialysis, with the final diagnosis being systemic amyloidosis with multiple myeloma [33]. Oweis et al reported a case of a 48-year-old man whose initial manifestation of multiple myeloma was focal segmental glomerulosclerosis [34].…”

Section: Renal Diseasementioning

confidence: 99%

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Uncommon Presentations of Multiple Myeloma

Tathineni¹,

Cancarevic²,

Malik³

2020

Cureus

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Multiple myeloma is a rare malignancy that exhibits a wide range of possible clinical presentations. In recent years, with the advent of stem cell transplantation, the prognosis of patients with multiple myeloma has been increasing. We searched the literature for reports of atypical myeloma presentations to aid clinicians in formulating differential diagnoses and to increase the number of cases diagnosed early. There have been a number of reports of early ocular symptoms, including, but not limited to, proptosis, optic neuropathy, vision loss, retinal hemorrhage, and detachment. Neurological presentations included cranial nerve palsies, vertigo related to cerebellar involvement, and diabetes insipidus related to pituitary involvement. Among gastrointestinal manifestations, there are a number of reports of multiple myeloma presenting as acute and chronic pancreatitis. Mesenteric ischemia due to amyloidosis, acute abdomen, and hepatosplenomegaly were also among reported presentations. When it comes to renal involvement, while acute renal failure and proteinuria are typical, there are reports of patients presenting with both nephritic and nephrotic forms of glomerular disease, as well as end-stage renal disease requiring dialysis. We believe that it is essential for clinicians to keep reporting atypical multiple myeloma presentations and consider it as a possible diagnosis in a patient with serious, atypical symptoms.

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Section: Renal Diseasementioning

confidence: 99%

Section: Renal Diseasementioning

confidence: 99%

Uncommon Presentations of Multiple Myeloma

Tathineni¹,

Cancarevic²,

Malik³

2020

Cureus

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“…El diagnostico definitivo se hace con la inmunohistoquimica, tinción rojo congo al microscopio bajo luz polarizada, lo que da su característico birrefringencia color verde manzana (Maturana-Ramírez et al, 2018).…”

Section: Discussionunclassified

Macroglosia en Amiloidosis Primaria como Clave Diagnostica: Reporte de un Caso

Vigouroux-Valenzuela

Donoso-Hofer

Ortega-Pinto

2021

Int. J. Odontostomat.

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RESUMEN:Amiloidosis se refiere a un grupo de enfermedades caracterizadas por el deposito extracelular de proteínas insolubles llamadas amiloide. La presentación intraoral de amiloidosis con macroglosia como signo primario es una entidad extraña, la cual puede afectar la funcionalidad de los pacientes aparte de la patología subyacente. Reportamos el caso de una paciente femenina de 85 años sin antecedentes mórbidos que al examen físico presenta macroglosia. La biopsia del tejido afectado fue estudiada bajo inmunohistoquimíca con tinción rojo congo, asociada al análisis de laboratorio que consignó un aumento en el componente monoclonal de cadenas livianas lambda. Se diagnosticó como amiloidosis primaria (AL). Se considera fundamental el entrenamiento al odontólogo general para el diagnóstico precoz de estos signos clínicos, por la baja sobrevida de la amiloidosis y la probabilidad de patologías ocultas como mieloma múltiple, el cual está asociado en un 20 % con AL.

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“…Dentro de las patologías sistémicas a tener en consideración, la amiloidosis cobra gran importancia dado que una detección y tratamiento precoz cambian el pronóstico de los pacientes que la padecen. En la literatura se describe que los pacientes con esta enfermedad presentan una sobrevida promedio entre 6-15 meses, usualmente falleciendo a causa del compromiso renal, falla cardíaca o neuropatía autonómica [10][11][12] .…”

Section: Discussionunclassified

“…La mayoría de los casos observados en cabeza y cuello afectan a la laringe y otros sitios menos frecuentes como tráquea, órbita, senos paranasales, oro y nasofaringe [13][14][15] . El depósito de amiloide en la lengua es extremadamente raro, y corresponde a menos del 9% de todos los tipos de amiloidosis 12,13 .…”

Section: Discussionunclassified

Amiloidosis AL y mieloma múltiple: Macroglosia como primera manifestación de una combinación infrecuente

2020

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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Macroglossia, the first manifestation of systemic amyloidosis associated with multiple myeloma: Case report

Cited by 13 publications

References 11 publications

Uncommon Presentations of Multiple Myeloma

Uncommon Presentations of Multiple Myeloma

Macroglosia en Amiloidosis Primaria como Clave Diagnostica: Reporte de un Caso

Amiloidosis AL y mieloma múltiple: Macroglosia como primera manifestación de una combinación infrecuente

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