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Pal P, Ray S, Patra SK, et al. Myeloma-associated systemic amyloidosis masquerading as NASH-associated cirrhosis and diabetic microvascular complications. Oxf Med Case Reports. 2015;2015(4):258-61doi: 10.1093/omcr/omv030.
Pal, P., Ray, S., Patra, S. K., Das, A. K., Dey, S., & George, R. (2015). Myeloma-associated systemic amyloidosis masquerading as NASH-associated cirrhosis and diabetic microvascular complications. Oxford medical case reports, 2015(4), 258-61. https://doi.org/10.1093/omcr/omv030
Pal, Partha, et al. "Myeloma-associated systemic amyloidosis masquerading as NASH-associated cirrhosis and diabetic microvascular complications." Oxford medical case reports vol. 2015,4 (2015): 258-61. doi: https://doi.org/10.1093/omcr/omv030
Pal P, Ray S, Patra SK, Das AK, Dey S, George R. Myeloma-associated systemic amyloidosis masquerading as NASH-associated cirrhosis and diabetic microvascular complications. Oxf Med Case Reports. 2015 Apr 13;2015(4):258-61. doi: 10.1093/omcr/omv030. eCollection 2015 Apr. PMID: 26634140; PMCID: PMC4664849.
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Oxf Med Case Reports. 2015 Apr 13;2015(4):258-61. doi: 10.1093/omcr/omv030. eCollection 2015 Apr.

Myeloma-associated systemic amyloidosis masquerading as NASH-associated cirrhosis and diabetic microvascular complications.

Oxford medical case reports

Partha Pal, Sayantan Ray, Sisir Kumar Patra, Anjan Kumar Das, Subhasis Dey, Rintu George

Affiliations

  1. Department of General Medicine , Calcutta National Medical College and Hospital , Kolkata, West Bengal , India.
  2. Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education & Research (IPGMER) and SSKM Hospital , Kolkata, West Bengal , India.
  3. Department of Pathology , Calcutta National Medical College and Hospital , Kolkata, West Bengal , India.

PMID: 26634140 PMCID: PMC4664849 DOI: 10.1093/omcr/omv030

Abstract

Authors describe the case of a 60-year-old diabetic man who presented with jaundice, ascites and significant weight loss over a period of 2 months. Physical examination revealed firm hepatomegaly with ascites. On evaluation, nephropathy, axonal neuropathy, carpal tunnel syndrome and decompensated cryptogenic liver disease with portal hypertension were found fitting with the diagnosis of diabetic nephropathy and neuropathy and nonalcoholic steato-hepatitis-associated cirrhosis, respectively. It was only after tissue diagnosis and serum protein electrophoresis that a definitive diagnosis of myeloma-related amyloidosis was made. This case emphasizes the fact that due to nonspecific initial presentation and multisystem involvement, a high index of suspicion and prompt use of appropriate tests including tissue diagnosis may be required to diagnose amyloid light-chain amyloidosis, which may be a rare presenting feature of myeloma. It should be differentiated from a commoner multisystem disease like diabetes and its complications.

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