Recurrent subconjunctival and periorbital haemorrhage as the first presentation of systemic AL amyloidosis secondary to myeloma

Abstract

suspicion is imperative in order not to miss a diagnosis of orbital cellulitis in this situation. Russo et al 4 have reported a case of orbital cellulitis in a patient with neuroblastoma without orbital metastasis. To the best of our knowledge, no presentation of orbital cellulitis in a case of metastatic orbital neuroblastoma has been hitherto reported. AcknowledgementsThe authors have no proprietary financial interests. This paper received no grants from public/private bodies.

Recurrent bilateral subconjunctival hemorrhage as an initial presentation of multiple myeloma

“…[1] Conjunctival involvement in amyloidosis associated with myeloma presents as subconjunctival hemorrhage presumably due to amyloid deposits in the walls of small vessels causing fragility. [45]…”

Subconjunctival hemorrhage: risk factors and potential indicators

“…Further evaluation for systemic disease is needed for these patients, although positive results are not often expected. Although the association of conjunctival amyloidosis with monoclonal gammopathies and multiple myeloma is not common, there is a case, reported by Higgins et al,26 presenting with recurrent SCH and periorbital hemorrhage as the first sign of systemic amyloid light-chain amyloidosis. In patients with systemic disease such as multiple myeloma, which can be associated with amyloidosis, recurrent SCHs may occur even in the absence of prominent amyloid deposits.…”

The Incidence of Senile Cataract and Glaucoma is Increased in Patients with Plasma Cell Dyscrasias: Etiologic Implications

“…Eye diseases were most common in AL amyloidosis patients probably because amyloid aggregates would be expected to interfere with lens structures and eye fluid drainage systems. AL amyloidosis patients had a particularly high risk (43.75) for ‘glaucoma secondary to eye inflammation’, probably because of amyloids causing chronic irritation of the eye 22 23 .…”

“…Case reports of secondary glaucoma in MM patients have also been published and an author of a case report on a glaucoma patient with MGUS speculated that the patient might have developed a hypercoagulable syndrome and obstructed blood flow to the optic nerve 22 31 . Recurrent subconjuctival and periorbital bleeding was reported in AL amyloidosis 23 .…”