. A 70-year old male has been experiencing intermittent epistaxis, fatigue and pain in bones for the past 4 months. Laboratory investigations are as follows : Serum Ca": 1F2 mg/dL (Normal 8-9-10-1mg/dL) This patient is likely to develop a complication of-
Amyloidosis is a group of diseases in which abnormal proteins, known as amyloid fibrils, build up in tissue.Symptoms depend on the type and are often variable.They may include diarrhea, weight loss, feeling tired, enlargement of the tongue, bleeding, numbness, feeling faint with standing, swelling of the legs, or enlargement of the spleen There are about 30 different types of amyloidosis, each due to a specific protein misfolding. Some are genetic while others are acquired. They are grouped into localized and systemic forms. The four most common types of systemic disease are light chain (AL), inflammation (AA), dialysis (Ab2M), and hereditary and old age (ATTR). Diagnosis may be suspected when protein is found in the urine, organ enlargement is present, or problems are found with multiple peripheral nerves and it is unclear why. Diagnosis is confirmed by tissue biopsy. Due to the variable presentation, a diagnosis can often take some time to reach. Treatment is geared towards decreasing the amount of the involved protein.This may sometimes be achieved by determining and treating the underlying cause.AL amyloidosis occurs in about 3-13 per million people per year and AA amyloidosis in about 2 per million people per year.The usual age of onset of these two types is 55 to 60 years old.Without treatment, life expectancy is between six months and four years.In the developed world about 1 per 1,000 people die from amyloidosis. Amyloidosis has been described since at least 1639 Ref Davidson 23rd edition pg 936
Floppy mitral valve
Autoimmune hemolytic anemia
Amyloidosis
Calcific aoic valve disease
Miscellaneous