文档介绍：该【Shoulder pad and macroglossia “two signs of AL amyloidosis” 2021 Navaneethakrishnan Suganthan 】是由【宝钗文档】上传分享，文档一共【2】页，该文档可以免费在线阅读，需要了解更多关于【Shoulder pad and macroglossia “two signs of AL amyloidosis” 2021 Navaneethakrishnan Suganthan 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。Received:27June2020 | Revised:8September2020 | Accepted:12October2020
DOI:
CLINICALIMAGE
Shoulderpadandmacroglossia:“twosignsofALamyloidosis”
Navaneethakrishnan Suganthan1 |Piratheepan Navaradnam2 |Vathulan Sujanitha1
1DepartmentofMedicine,Universityof
Jaffna,Jaffna,SriLankaAbstract
2UniversityMedicalUnit,Teaching“Shoulderpad”signresultingfromdepositionofamyloidintheperiarticularsofttis-
Hospital,Jaffna,SriLankasueisrarebutitispathognomonicforimmunoglobulinamyloidosis(AL).Although
thedetectionremainsachallenge,itgivesastrongclueleadingtopromptdiagnosis.
Correspondence
NavaneethakrishnanSuganthan,
DepartmentofMedicine,UniversityofKEYWORDS
Jaffna,Jaffna,,lightchain,macroglossia,shoulderpadsign
Email:drn.******@
1 | -recognizedcausefor
macroglossiaand“shoulderpadsign”resultingfromdepo-
Immunoglobulinamyloidosisisawell-recognizedcauseforsitionofamyloidintheperiarticularsofttissuewhichis
macroglossiaandshoulderpadsign.“Shoulderpad”signre-
sultingfromdepositionofamyloidintheperiarticularsoftThediagnosisofALamyloidosisisusuallyestablished
tissueisrarebutitispathognomonicforimmunoglobulinwithanabdominalfatpadaspiratebecauseoftheirease,
amyloidosis(AL).Althoughthedetectionremainsachal-convenience,
lenge,,consid-
An83-year-oldwomanonabackgroundofdiabeteseringageandothercomorbiddiseases,shewassenthomeon
mellitus,hypertension,bronchialasthma,andstableanginapalliativecareasperherdecision.
presentedwithahistoryofincreasinglethargyandloss
ofappetiteof6 
tonguewasenlarginginsizeandincreasinglystiffwithdif-
ficultyinswallowingandtalkingoverthecourseofthepre-
vious2 ,
visibleenlargementofbothanteriorshoulders(shoulder
padsign),infiltrationofupperlip,andmultiplepapules
andnodulesoverthechest,neck,andarms(Figure 1).
Laboratorystudiesshowednormochromicnormocytic
anemia,elevatedESR,
proteinelectrophoresisdidnotshowMbandbutBence
ofabdomenrevealedhepatomegalywithearlychronickid-
neydisease,andtransthoracicechocardiogramwasunre-
thediagnosisofamyloidosis(Figure 2A,B).Ultimately,FIGURE1 Itshowsmacroglossiawithenlargementofboth
shewasdiagnosedwithALamyloidosis,withamyloidfi-anteriorshoulders(shoulderpadsign),infiltrationofupperlip,and
brilsderivedfromthemonoclonallight-chaindepositinmultiplepapulesandnodulesonchestandarms
ThisisanopenaccessarticleunderthetermsoftheCreativeCommonsAttributionLicense,whichpermitsuse,distributionandreproductioninanymedium,providedtheoriginal
workisproperlycited.
©&SonsLtd.
| 1801;9:1801–1802.
1802 | SUGANTHANetal.
(A)CONFLICTOFINTEREST
Theauthorsdeclarethattheyhavenocompetinginterests.
AUTHORCONTRIBUTIONS
NSandPN:providedmedicalcareandcollectedalldata;NS,
PN,andVS:involvedinpreparationofmanuscript;allau-
thorsreadandapprovedthefinalmanuscript.
CONSENTFORPUBLICATION
Informedwrittenconsentforthepublicationwasobtained
fromthepatient.
(B)
ORCID
NavaneethakrishnanSuganthan https://orcid.
org/0000-0001-7905-6709
PiratheepanNavaradnam https://orcid.
org/0000-0002-8984-2719
VathulanSujanitha https://orcid.
org/0000-0003-0330-7254
REFERENCES
,BurtC,-padsignofamyloidosis:
FIGURE2 A,Thisbiopsy(H&E);54(4):404-
extracellulardepositsofeosinophilichomogenousmaterial(:///-
arrow).B,Amyloiddepositionshowsapplegreenbirefringent(,MilaniP,PalladiniG,
arrow);58:48-
collagen(shortarrow):///
ACKNOWLEDGMENTHowtocitethisarticle:SuganthanN,NavaradnamP,
:“twosigns
”.;9:1801–1802.
wishtothankthehistopathologistsforhelpingtoarriveata/
diagnosis.