Management of laryngeal amyloidosis

Abstract

Amyloidosis of the upper aerodigestive tract is rare. However, the larynx is the commonest site within the upper airways to be affected. Three cases of uncomplicated primary amyloidosis of the larynx and one case of laryngeal amyloidosis with more generalized dissemination throughout the head and neck are presented. In this article the different presentations of laryngeal amyloidosis and principles of management of this condition at that site are highlighted.

KTP Laser in Laryngeal Amyloidosis: Five Cases with Review of Literature

“…Hoarseness is the most common symptom [4,5,16,18]. All the three patients in our study presented with hoarseness.…”

“…Fullness in the ventricular band is the commonest sign [4]. In our clinical experience, ventricular band fullness is the commonest clinical sign on indirect laryngoscopy.…”

“…They include full blood counts, erythrocyte sedimentation rate, electrolyte, chest x-ray, renal function test, liver function test, thyroid function test, electrocardiogram, echo cardiography, serum and urine electrophoresis, urine Bence Jones protein, serum immunoglobulin level, b 2 microglobulin level, bronchoscopy, chest CT [4,20]. Some authors have suggested work up for assessment of collagen vascular diseases, tuberculosis, multiple myeloma, extramedullary plasmacytoma, rheumatoid factor, anti-nuclear antibody, purified protein derivatives, associated familial syndromes and endocrinopathies [17].…”

“…However there have been documented cases of laryngeal amyloidosis with systemic involvement (primarily in the upper respiratory tract and stomach) [18]. Hence, indications for such invasive investigation are limited to patients with laryngeal amyloidosis who have manifestations of other system involvement such as impaired renal function [4].…”

“…Congo red staining shows apple green birefringence under a polarized light microscope [3]. Amyloidosis can be hereditary or acquired, systemic or localized [4]. Larynx is the commonest site of involvement in the head and neck [5].…”