Amyloidosis physical examination: Difference between revisions

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== Overview ==
== Overview ==
Common findings in amyloidosis include [[petechiae]], [[ecchymosis]], [[parotid gland enlargement]], increased [[intraocular pressure]], [[enlarged tongue]], [[hepatomegaly]], [[carpal tunnel syndrome]], and [[Raynaud's phenomenon]].
Common findings in amyloidosis include waxy thickening, [[easy bruising]], [[purpura]], macroglossia, [[parotid gland]] and [[submandibular gland]] enlargement, [[edema]], [[numbness]] and [[paresthesia]].


==Physical Examination==
==Physical Examination==
<ref name="pmid267192344">{{cite journal |vauthors=Wechalekar AD, Gillmore JD, Hawkins PN |title=Systemic amyloidosis |journal=Lancet |volume=387 |issue=10038 |pages=2641–2654 |date=June 2016 |pmid=26719234 |doi=10.1016/S0140-6736(15)01274-X |url=}}</ref><ref name="pmid267192344">{{cite journal |vauthors=Wechalekar AD, Gillmore JD, Hawkins PN |title=Systemic amyloidosis |journal=Lancet |volume=387 |issue=10038 |pages=2641–2654 |date=June 2016 |pmid=26719234 |doi=10.1016/S0140-6736(15)01274-X |url=}}</ref><ref name="pmid267192344">{{cite journal |vauthors=Wechalekar AD, Gillmore JD, Hawkins PN |title=Systemic amyloidosis |journal=Lancet |volume=387 |issue=10038 |pages=2641–2654 |date=June 2016 |pmid=26719234 |doi=10.1016/S0140-6736(15)01274-X |url=}}</ref><ref name="pmid14660909">{{cite journal |vauthors=Pribitkin E, Friedman O, O'Hara B, Cunnane MF, Levi D, Rosen M, Keane WM, Sataloff RT |title=Amyloidosis of the upper aerodigestive tract |journal=Laryngoscope |volume=113 |issue=12 |pages=2095–101 |date=December 2003 |pmid=14660909 |doi=10.1097/00005537-200312000-00007 |url=}}</ref>
[[Physical examination]] of patients with amyloidosis is usually remarkable for waxy thickening, [[easy bruising]], [[purpura]], [[macroglossia]], [[parotid gland]] and [[submandibular gland]] enlargement, [[edema]], [[numbness]] and [[paresthesia]].<ref name="pmid267192344">{{cite journal |vauthors=Wechalekar AD, Gillmore JD, Hawkins PN |title=Systemic amyloidosis |journal=Lancet |volume=387 |issue=10038 |pages=2641–2654 |date=June 2016 |pmid=26719234 |doi=10.1016/S0140-6736(15)01274-X |url=}}</ref><ref name="pmid14660909">{{cite journal |vauthors=Pribitkin E, Friedman O, O'Hara B, Cunnane MF, Levi D, Rosen M, Keane WM, Sataloff RT |title=Amyloidosis of the upper aerodigestive tract |journal=Laryngoscope |volume=113 |issue=12 |pages=2095–101 |date=December 2003 |pmid=14660909 |doi=10.1097/00005537-200312000-00007 |url=}}</ref><ref name="pmid23239211">{{cite journal |vauthors=Shin SC, Robinson-Papp J |title=Amyloid neuropathies |journal=Mt. Sinai J. Med. |volume=79 |issue=6 |pages=733–48 |date=2012 |pmid=23239211 |pmc=3531896 |doi=10.1002/msj.21352 |url=}}</ref><br />
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with amyloidosis usually appear normal.
*Patients with amyloidosis usually appear normal.
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*Waxy thickening
*Waxy thickening
*Easy bruising (ecchymoses)
*Easy bruising (ecchymoses)
*Subcutaneous nodules or plaques
*Subcutaneous [[nodules]] or [[plaques]]
*Purpura
*[[Purpura]]
* [[Petechiae]]  
* [[Petechiae]]  
* Brittle nails
* Brittle nails
* Edema  
*[[Edema]]
*Diffuse or patchy alopecia
*Diffuse or patchy [[alopecia]]
*Nail dystrophy  
*Nail dystrophy  
*Brittle nails
*Brittle nails
*Plaques may be seen
 
**Eyelids
**Retroauricular region
**Neck
**Inguinal and anogenital regions
===HEENT===
===HEENT===
*Macroglossia
*[[Macroglossia]]
*[[Parotid gland]] enlargement
*[[Parotid gland]] enlargement
* Submandibular gland enlargement
*[[Submandibular gland]] enlargement
*Peri-orbital purpura
*Peri-orbital [[purpura]]
* Raised intraocular pressure may be seen.
* Raised [[intraocular pressure]] may be seen.
*Visual and hearing loss may be seen.
*Visual and hearing loss may be seen.


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===Lungs===
===Lungs===
*Hoarseness
*[[Hoarseness]]
*Stridor
*[[Stridor]]
*Dysphagia
*[[Dysphagia]]


===Heart===
===Heart===
*Arrhythmia  
*[[Arrhythmia]]


===Abdomen===
===Abdomen===
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===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with amyloidosis is usually normal.
*[[Genitourinary]] examination of patients with amyloidosis is usually normal.


===Neuromuscular===
===Neuromuscular===
*Numbness
*[[Numbness]]
*Paresthesia
*[[Paresthesia]]
*Pain
*Pain


===Extremities===
===Extremities===
*Edema
*[[Edema]]
* [[Carpal tunnel syndrome]]
* [[Carpal tunnel syndrome]]
* [[Numbness]] of the fingers and toes
* [[Numbness]] of the fingers and toes
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===Macular Amyloidosis===
===Macular Amyloidosis===
<gallery widths=130px>
<gallery widths="130px">


291.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]
291.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]
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===Nodular Amyloidosis===
===Nodular Amyloidosis===
<gallery widths=130px>
<gallery widths="130px">


297.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]
297.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]

Latest revision as of 21:19, 17 December 2019

Amyloidosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]

Overview

Common findings in amyloidosis include waxy thickening, easy bruising, purpura, macroglossia, parotid gland and submandibular gland enlargement, edema, numbness and paresthesia.

Physical Examination

Physical examination of patients with amyloidosis is usually remarkable for waxy thickening, easy bruising, purpura, macroglossia, parotid gland and submandibular gland enlargement, edema, numbness and paresthesia.[1][2][3]

Appearance of the Patient

  • Patients with amyloidosis usually appear normal.

Vital signs

Skin

HEENT


Neck

  • Neck examination of patients with amyloidosis is usually normal.

Lungs

Heart

Abdomen

Back

  • Back examination of patients with amyloidosis is usually normal.

Genitourinary

  • Genitourinary examination of patients with amyloidosis is usually normal.

Neuromuscular

Extremities

Macular Amyloidosis

Nodular Amyloidosis

References

  1. Wechalekar AD, Gillmore JD, Hawkins PN (June 2016). "Systemic amyloidosis". Lancet. 387 (10038): 2641–2654. doi:10.1016/S0140-6736(15)01274-X. PMID 26719234.
  2. Pribitkin E, Friedman O, O'Hara B, Cunnane MF, Levi D, Rosen M, Keane WM, Sataloff RT (December 2003). "Amyloidosis of the upper aerodigestive tract". Laryngoscope. 113 (12): 2095–101. doi:10.1097/00005537-200312000-00007. PMID 14660909.
  3. Shin SC, Robinson-Papp J (2012). "Amyloid neuropathies". Mt. Sinai J. Med. 79 (6): 733–48. doi:10.1002/msj.21352. PMC 3531896. PMID 23239211.

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