Amyloidosis presenting with Nephrotic Syndrome and cardiac disease: A case report

Abstract

Amyloidosis is a heterogeneous disease that results from the deposition of toxic insoluble beta-sheet fibrils protein aggregates in different tissues. It can either be acquired or inherited. The estimated incidence stands at 1 case per 100,000 person-years in Western countries. Other data indicates that it is rare, only affecting 5-12 million people globally per year. The mean age of diagnosis is 63 years, though it’s most common in ages above 65 years. A diagnostic and differentiating feature of amyloidosis is the apple-green birefringence of amyloid on Congo red staining. Cyclophosphamide, bortezomib, dexamethasone, and melphalan combinations have proved treatment choices for AL amyloidosis. Mortality and morbidity depend on the organ involved, with cardiovascular involvement having high mortality and morbidity. This is a case report of an elderly, African female diagnosed with multiple myeloma and associated amyloidosis, presenting with worsening nephrotic syndrome and cardiac involvement in a private tertiary Kenyan hospital.