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A 61-year-old man presented to the hematology department with progressive difficulty in swallowing food. He also described a 2-year history of edema in his hands and face as well as dry skin and hair loss. Physical examination of the oropharynx showed macroglossia (abnormal enlargement of the tongue) with posterior scalloping, erythema of the palatoglossal arch, and an enlarged uvula. Biopsy of the uvula was performed, and staining with Congo red showed apple-green birefringence suggestive of amyloid deposits. Immunohistochemical analysis showed high circulating levels of kappa light chain. Serum electrophoresis with immunofixation revealed a monoclonal spike of 0.4 g per deciliter. Additional evaluation was notable for a level of free kappa light chain of 56.6 mg per liter (reference range, 8.3 to 27.0), an elevated ratio of kappa to lambda light chains of 3.3 (reference range, 0.26 to 1.65), and proteinuria (0.26 g of protein in a 24-hour urine sample). Flow cytometry of bone marrow showed 0.54% plasma cells with an atypical phenotype, and cardiac magnetic resonance imaging was suggestive of amyloid involvement in the left ventricular myocardium. Amyloidosis is characterized by deposition of abnormal proteins in extracellular tissue; in the light-chain form of the disease, the extracellular tissue is derived from immunoglobulin light chains associated with a plasma-cell dyscrasia. The patient underwent autologous bone marrow transplantation and had a complete response

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Thank you for your nicely explained presentation of the case ,I have not seen this type of patient

Thank you doctor
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Very Informative post sir

do like and Share dear
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Good case presented Thanx for that But was it present else where in the body to be ruled out

How was it treated further and follwed up
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A c/o autoimmune disease amyloidosis Thanx for good elaboration and sharing the case

Thank you doctor
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Thanks for sharing an unusual case

Thank you doctor
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Thank You so mich Sir,