Secondary systemic amyloid

Symptoms:

• fatigue
• numbness of hands and feet
• weak hand grip
• weight loss
• shortness of breath
• swelling of the extremities
• swallowing difficulties
• irregular heart rhythm
• bleeding in the skin
• enlarged tongue

Signs and tests:

If specific organ damage is suspected, the testing to confirm amyloidosis of that organ may include a biopsy of an affected tissue or organ that is positive for amyloid (skin biopsy which includes subcutaneous fat, rectal mucosa biopsy, or bone marrow biopsy are convenient, safe, and likely to be positive).

The physical examination or abdominal ultrasound shows an enlarged liver or spleen.

Cardiac evaluation reveals arrhythmias, abnormal heart sounds, or signs of heart failure:

• ECG shows abnormalities
• echocardiogram shows poor wall motion because of stiff heart muscle (cardiomyopathy)

Renal evaluation reveals renal failure or nephrotic syndrome:

• urinalysis that shows protein, casts, or fat bodies
• increased serum creatinine
• increased BUN

There may also be an evaluation for carpal tunnel syndrome:

• nerve conduction velocity that shows conduction block
• weak hand grip associated with weakness of the thumb