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. A similar proportion of patients may have a monoclonal band in the urine but this may only be visible after urinary concentration. Immunohistochemical staining, if available, will show a striking predominance of lamda or kappa depending on the type of immunoglobin produced.