title: Fixed digital contractures revealing light-chain amyloidosis.
abstract: Among the many clinical manifestations of light-chain (AL) amyloidosis, musculoskeletal involvement is rarely reported. We describe the case of a 72-year-old woman who was referred to our rheumatology department for fixed flexion contractures of the fingers that developed concomitantly with a decline in general health. Macroglossia and recent-onset dyspnea were noted. Investigations, which included a tongue biopsy, established the diagnosis of kappa light-chain amyloidosis with soft tissue, bone, and cardiac deposits. Melphalan and dexamethasone therapy was successful in stabilizing the clinical and laboratory abnormalities within 6 months. This case is remarkable in that the musculoskeletal manifestations were at the forefront of the clinical picture and led to the diagnosis.
authors.affiliation: Service de rhumatologie, Hôpital d'adultes de Brabois, CHU Nancy, Avenue de Bourgogne, 54511 Vandoeuvre-lès-Nancy, France.
authors.forename: Félicie
authors.initials: F
authors.lastname: Costantino
authors.forename: Damien
authors.initials: D
authors.lastname: Loeuille
authors.forename: Hervé
authors.initials: H
authors.lastname: Dintinger
authors.forename: Patrice
authors.initials: P
authors.lastname: Péré
authors.forename: Isabelle
authors.initials: I
authors.lastname: Chary-Valckenaere
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D003286:Contracture / Q000175:diagnosis / Q000209:etiology*; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005384:Finger Joint; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000378:metabolism*; D008558:Melphalan / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007145:Immunoglobulin kappa-Chains; D003907:Dexamethasone; D008558:Melphalan