Mendelson listed some clinical red flags that may be subtle clues for light chain amyloidosis in a patient with an underlying myeloma. Recognizing these symptoms can shorten the delay in diagnosis that is common in this disorder. The authors are from Boston University and Boston Medical Center.
Patient selection: light chain amyloidosis associated with myeloma
Clinical red flags
(1) joint pain with decreased range of motion and swelling (amyloid arthropathy)
(2) pseudohypertrophy of the deltoid muscle (shoulder pad sign)
(3) other soft tissue masses
(4) macroglossia
(5) swelling of submandibular glands
(6) swelling of lacrimal glands
(7) periorbital ecchymosis
(8) dyspnea and/or edema with or without chest pain (cardiac amyloidosis)
(9) syncope
(10) fatigue
(11) gastrointestinal complaints
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