Reprints of this article may be obtained by e-mailing us at the above address. Amyloidosis gives rise to a constellation of signs and symptoms but a major clue is the presence of cardiac or renal disease in a middle aged to elderly patient who also has signs or symptoms of other organ involvement. If the diagnosis of amyloidosis is suspected based on symptoms in one organ system, a search should be made for involvement of other organs. Low voltage or extreme axis deviations on the electrocardiogram point to cardiac involvement and echocardiography often shows a thickened ventricle. 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.