  For a patient with manifestations of nausea, abdominal distension,
spontaneous splenic rupture, obvious liver enlargement, low red blood cells and
platelets, yellow sclera, and spider angioma, Congo red staining of liver and
spleen tissues indicated amyloidosis. After secondary factors were excluded,
the patient was finally diagnosed as chronic liver failure, light chain
amyloidosis, spontaneous bacterial peritonitis after cystic resection and
splenectomy. This case suggests that for patients with chronic liver failure
accompanied by spontaneous splenic rupture and hepatomegaly for unknown
reasons, the possibility of amyloidosis should be considered after excluding
other factors, such as viral liver disease, autoimmune disease, alcoholic liver
disease, genetic metabolic liver disease and liver tumor, and etc. Considering
the low clinical incidence rate and poor prognosis, relevant diagnosis depends
on the biopsy results, and many patients were not confirmed until autopsy after
death. Therefore, once amyloidosis is suspected, it is necessary to have
communications with relevant patients and their families on the risks for
examination, treatment methods and prognosis as soon as possible.
