Amyloidosis physical examination

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Primary amyloidosis
Secondary amyloidosis
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Beta-2 microglobulin related amyloidosis
Gelsolin related amyloidosis
Lysozyme amyloid related amyloidosis
Leucocyte cell-derived chemotaxin 2 related amyloidosis
Fibrinogen A alpha-chain associated amyloidosis

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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 petechiae, ecchymosis, parotid gland enlargement, increased intraocular pressure, enlarged tongue, hepatomegaly, carpal tunnel syndrome, and Raynaud's phenomenon.

Physical Examination

[1][1][1][2]

Appearance of the Patient

  • Patients with amyloidosis usually appear normal.

Vital signs

Skin

  • Waxy thickening
  • Easy bruising (ecchymoses)
  • Subcutaneous nodules or plaques
  • Purpura
  • Petechiae
  • Brittle nails
  • Edema
  • Diffuse or patchy alopecia
  • Nail dystrophy
  • Brittle nails
  • Plaques may be seen
    • Eyelids
    • Retroauricular region
    • Neck
    • Inguinal and anogenital regions

HEENT

  • Macroglossia
  • Parotid gland enlargement
  • Submandibular gland enlargement
  • Peri-orbital purpura
  • Raised intraocular pressure may be seen.
  • Visual and hearing loss may be seen.


Neck

  • Neck examination of patients with amyloidosis is usually normal.

Lungs

  • Hoarseness
  • Stridor
  • Dysphagia

Heart

  • Arrhythmia

Abdomen

Back

  • Back examination of patients with amyloidosis is usually normal.

Genitourinary

  • Genitourinary examination of patients with amyloidosis is usually normal.

Neuromuscular

  • Numbness
  • Paresthesia
  • Pain

Extremities

Macular Amyloidosis

Nodular Amyloidosis

References

  1. 1.0 1.1 1.2 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.

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