Primary amyloidosis is a disorder in which protein fibers are deposited in tissues and organs, harming them.
Alternative Names
Amyloid - primary
Causes
The cause of primary amyloidosis is unknown, but the condition is related to abnormal production of antibodies by a type of immune cell called plasma cells.
The symptoms depend on the organs affected by the deposits. These organs can include the tongue, intestines, skeletal and smooth muscles, nerves, skin, ligaments, heart, liver, spleen, and kidneys.
Primary amyloidosis can result in conditions that include:
An abdominal fat pad biopsy, rectal mucosa biopsy, or a bone marrow biopsy can help confirm the diagnosis.
A heart evaluation, including an ECG,may reveal arrhythmias, abnormal heart sounds, or signs of congestive heart failure. An echocardiogram shows poor motion of the heart wall, due to a stiff heart muscle.
A carpal tunnel syndrome evaluation may show that hand grips are weak.Nerve conduction velocity shows abnormalities.
Kidney function tests may show signs of kidney failure or too much protein in the urine ( nephrotic syndrome).
Some patients with primary amyloidosis respond to chemotherapy directed at the abnormal plasma cells. Stem cell transplantation may be used, as in multiple myeloma.
In secondary amyloidosis, aggressive treatment of the underlying disease can improve symptoms and/or slow progression of disease. Complications such as heart failure, kidney failure, and other problems can sometimes be treated as necessary.
Outlook (Prognosis)
The severity of the disease depends upon the organs affected. Heart and kidney involvement may lead to organ failure and death. Systemic involvement is associated with death within 1 to 3 years.
Possible Complications
Congestive heart failure
Death
Endocrine failure (hormonal disorder)
Kidney failure
Respiratory failure
When to Contact a Medical Professional
Call your health care provider if symptoms consistent with primary amyloidosis develop.
If you know you have primary amyloidosis, call your health care provider if difficulty breathing, persistent swelling of the ankles or other areas, decreased urine output, or other symptoms occur. This may indicate that complications have developed.
Prevention
There is no known prevention.
References
Buxbaum JN. The Amyloidoses. In: Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: WB Saunders; 2004.
Hoffman R, Benz Jr. EJ, Shattil SJ, et al., eds. Hematology: Basic Principles and Practice. 4th ed. Philladelphia, Pa: Churchill Livingston; 2005:1540-48.
Review Date:
2/23/2009
Reviewed By:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.