The urine should be checked for protein as nephrotic syndrome is common and a careful physical examination should be performed with special attention to the presence of hepatomegaly which may indicate hepatic infiltration. Pulmonary involvement is rare and symptoms of dyspnea usually indicate congestive heart failure. Central nervous system manifestations are very rare. Gastrointestinal involvement may be characterized by early satiety and diarrhea although many of the gastrointestinal manifestations are actually a function of an autonomic neuropathy which interferes with motility. Abnormalities will depend on the organ system involved.
Anemia is uncommon, unless the amyloidosis is associated with myeloma.
However, the sedimentation rate is often increased. Proteinuria is common. Abnormalities of liver function tests related to amyloid are predominantly limited to an elevated alkaline phosphatase. Serum cholesterol may be markedly elevated in patients with nephrotic syndrome. Intensity of the spike is generally much less than in patients with multiple myeloma.