Systemic amyloidosis AL with temporal artery involvement revealing lymphoplasmacytic malignancy in a man presenting as polymyalgia rheumatica
Article Abstract:
A 68-year-old man with a suspected case of polymyalgia rheumatica was diagnosed with AL systemic amyloidosis involving the temporal artery and lymphoplasmacytic malignancy. Polymyalgia rheumatica occurs in the elderly and is characterized by joint and muscle pain. Systemic amyloidosis is the accumulation of insoluble fibrillar proteins, in this case, AL proteins. The man complained of pain and stiffness in his neck and shoulders. Blood tests and measures of enzyme activity were all normal. A biopsy of his temporal artery, however, revealed massive amyloid deposits. Amyloid deposits in small blood vessels are common, but the involvement of a large vessel as seen in this man is rare. Further tests indicated he also had muscular, rectal and possibly heart amyloidosis. Samples taken from his bone marrow showed malignancy. This case highlights the importance of considering diseases like amyloidosis when polymyalgia rheumatica is suspected as symptoms of polymyalgia rheumatica are not specific to the disorder.
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1993
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Decreased serum apolipoprotein AII/AI ratio in systemic amyloidosis
Article Abstract:
The ratio of apolipoproteins (apo) in the blood may indicate the presence of amyloidosis, a condition in which amyloid protein fibrils form damaging deposits in organs. Researchers measured apoAI and apoAII in patients with rheumatoid arthritis, multiple myeloma, and kidney disease, some of whom also had amyloidosis. The apoAII/AI ratio was significantly lower in patients with amyloidosis, and a ratio of 0.2 was diagnostic for the disease. In patients with suspected amyloidosis, the apolipoprotein ratio may be useful in confirming the diagnosis.
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1998
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Polymyalgia and low back pain: a common cause not to be missed
Article Abstract:
The authors compare two patients, one a 65 year old man with severe sciatica, the other a 70 year old woman with backache and pain continuing on down through her thighs, knees and feet. They explain which symptoms prompted successive tests which ultimately identified the underlying cause in both cases as cancer of the kidney.
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1999
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