What are the common symptoms of amyloidosis?

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What are the common symptoms of amyloidosis?

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So things

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that should prompt us as clinicians or even patients to think about amyloidosis, There's a pretty good list.

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these are all things that really, as an oncologist or hematologist, as we're seeing patients, when we see someone with a new diagnosis of, let's say, smoldering myeloma or multiple myeloma, if they have these other red flag symptoms, then they really should prompt us to think about amyloidosis.

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And these are often things that we see in amyloidosis that we really don't see in myeloma.

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so the various items that I would typically think about would be heart failure. So somebody with a new diagnosis of, again, smoldering or active multiple myeloma who has new heart failures, a shortness of breath, peripheral edema or leg swelling,

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or other signs or symptoms of heart failure or electrical trouble in the heart.

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So what we call a arrhythmias, So basically short circuits or abnormal heart rhythms,

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those things are often red flags for amyloidosis. Not always, but we should think about it

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someone with multiple myeloma who has,

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what we call nephrotic range proteinuria, which just means a lot of protein leaking out from through the kidneys into the urine. That's another thing that typically doesn't happen in multiple myeloma.

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If it does, it should prompt us to think about

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amyloidosis.

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Someone who has a lot of neuropathy, some numbness and tingling in the fingers and toes, a little bit of that goes with myeloma. A lot of that, especially if accompanied by severe GI symptoms like constipation, diarrhea

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or really low blood pressures, those are all things that could indicate different patterns of nerve injury.

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And they should prompt us to think about amyloidosis

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tongue enlargement. So it sounds strange, but when people have amyloidosis

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of the light chain variety, one thing that we sometimes see is enlargement of the tongue as that protein deposits in the tongue,

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and so it causes significant tongue enlargement and can even cause trouble with swallowing for some people who have it severely.

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That's another red flag symptom.

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so you get the sense from this list there are things that that we see

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that if we see them in somebody who has a diagnosis of multiple myeloma, we really need to think about whether there is an amyloidosis component of it. Also,

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So the most common symptoms of amyloidosis include protein in the urine.

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we're referring to albumin in the urine rather than excessive amounts of light chains in the urine that's a big red flag.

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Peripheral neuropathy in a stock in glove distribution and usually sensory

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is common. That can look a lot like the neuropathy people get from chemotherapy. So that may be hard to pick up or recognize as being related to amyloidosis.

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another

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potential symptom if the amyloid affects your heart is congestive heart failure. So any patient who develops unexplained symptoms of congestive heart failure during the course of their treatment for multiple myeloma should should be screened or evaluated for the possibility of amyloidosis.

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What are some symptoms of congestive heart failure?

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so symptoms of congestive heart failure could be excessive unexplained fatigue or exercise intolerance, shortness of breath, particularly if there's fluid accumulation in the lungs or progressive

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swelling in the legs

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or edema. That doesn't have another explanation.

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Usually congestive heart failure associated with chest pain or anything like that

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Where can individuals find additional resources on amyloidosis?

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So the patient advocacy groups, the Amyloidosis Foundation, the Amyloidosis Research Consortium and the amyloidosis support groups, the major patient advocacy groups have wonderful websites.

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Many of the hospitals, Tufts, for example, Mayo Clinic, Boston Medical Center, Memorial Sloan Kettering, Columbia, have a websites which are very informative. The National Cancer Institute also has a fairly good website on amyloidosis. There's a lot of information online.

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Some of that is a little outdated, but the symptomatology that's described is still accurate.