Video

Dr. Wong on the Difficulty of Diagnosing Patients With AL Amyloidosis

Author(s):

Sandy Wong, MD, assistant professor, University of California, San Francisco School of Medicine, discusses the presentation of AL amyloidosis in patients.

Sandy Wong, MD, assistant professor, University of California, San Francisco School of Medicine, discusses the presentation of AL amyloidosis in patients.

Treating amyloidosis is only one of the difficulties of the disease. The other difficulty lies in diagnosing the disease which is known to cause a unique pattern of organ involvement in every patient and mimic other common conditions. In AL amyloidosis, around 60-70% of patients have cardiac and/or renal involvement. When it affects the heart, the disease causes an infiltrative cardiomyopathy which is typically a symptom of heart failure.

Swelling in the legs and shortness of breath, especially from exertion, are other common symptoms. If it affects the kidneys, it can cause decreases in the filtration rate of the kidneys and can also cause spillage of protein into the urine. Amyloid can also deposit in other organs in the body such as the gut, the liver, and the peripheral nerves.

These symptoms are commonly linked to other causes because AL amyloidosis is not a common disease and therefore not typically diagnosed until late in its course.

Related Videos
Julia Rotow, MD, clinical director, Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute; assistant professor, medicine, Harvard Medical School
Joshua K. Sabari, MD, assistant professor, Department of Medicine, New York University Grossman School of Medicine; director, High Reliability Organization Initiatives, Perlmutter Cancer Center
Alastair Thompson, BSc, MBChB, MD, FRCS
C. Ola Landgren, MD, PhD
Sara M. Tolaney, MD, MPH
Adam M. Brufsky, MD, PhD, FACP
Justin M. Watts, MD
Sara M. Tolaney, MD, MPH
Leah Backhus, MD, MPH, FACS, professor, University Medical Line, Cardiothoracic Surgery, co-director, Thoracic Surgery Clinical Research Program, associate program director, Thoracic Track, CT Surgery Residency Training Program, Thelma and Henry Doelger Professor of Cardiovascular Surgery, Stanford Medicine; chief, Thoracic Surgery, VA Palo Alto
Roy S. Herbst, MD, PhD, Ensign Professor of Medicine (Medical Oncology), professor, pharmacology, deputy director, Yale Cancer Center; chief, Medical Oncology, director, Center for Thoracic Cancers, Yale Cancer Center and Smilow Cancer Hospital; assistant dean, Translational Research, Yale School of Medicine