“An 82-year-old white male consults you following several syncopal episodes that are clearly orthostatic in nature. During the course of your evaluation, you find that he has a large tongue, mild cardiomegaly, and findings that suggest bilateral carpal tunnel syndrome. The most likely diagnosis at this time is Amyloidosis.”
“Amyloidosis is defined as the extracellular deposition of the fibrous protein amyloid at one or more sites. It may remain undiagnosed for years. Features that should alert the clinician to the diagnosis of primary amyloidosis include unexplained proteinuria, peripheral neuropathy, enlargement of the tongue, cardiomegaly, intestinal malabsorption, bilateral carpal tunnel syndrome, and orthostatic hypotension. Amyloidosis occurs both as a primary idiopathic disorder and in association with other diseases such as multiple myeloma.” ABFM critique