Case history
Case history #1
A 79-year-old man presents with dyspnea on exertion for 1 year and lower extremity edema. As part of a cardiac evaluation, the echocardiogram shows concentric left ventricular hypertrophy. Cardiac catheterization shows normal coronary arteries and he is referred for further evaluation of noncardiac dyspnea.
Case history #2
A 62-year-old man is referred for management of atypical multiple myeloma. He has mild anemia (hemoglobin 12 g/dL) and urinary protein loss of 2.2 g/day. Urine immunofixation electrophoresis shows free lambda light chains. Bone marrow examination shows 5% plasma cells and does not fulfill criteria for multiple myeloma.
Other presentations
Patients with amyloidosis may present with unexplained cardiomyopathy, nondiabetic proteinuria, unexplained hepatomegaly, axonal or demyelinating peripheral neuropathy with autonomic features, or atypical multiple myeloma.
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