title: Systemic amyloidosis with bilateral conjunctival involvement: a case report.
abstract: BACKGROUND
  Conjunctival amyloidosis is a very rare condition, generally unilateral, and presents mostly as an isolated condition without systemic compromise. Our purpose is to present a new case of systemic amyloidosis with a bilateral conjunctival involvement.
  
  
  METHODS
  A 66-years-old caucasian female complaining of conjunctival hemorrhage and chemosis in both eyes for the last five years had been discontinuously treated with topical antibiotics and corticosteroids without any evident improvement. She presented with a pink-yellow infiltration in the inferior conjunctiva of both eyes. Conjunctival biopsy under optical microscopy revealed amyloid deposit, confirmed by Congo red staining. Mucosal biopsy from esophagus and rectus confirmed amyloidosis by Congo red stain. Immunohistochemistry of bone marrow biopsy showed an increased number of plasma cells and an over-expression of light chain kappa subunit. She was treated with corticosteroids and lubrication with an improvement of symptoms. Ocular lesions remained stable after a follow-up of 3 years.
  
  
  CONCLUSIONS
  Conjunctival amyloidosis is a rare entity that may be overlooked, and should be differentiated from chronic conjunctivitis and conjunctival malignancies. Although it presents most frequently as a local process, a systemic involvement should always be ruled out.
authors.affiliation: Department of Ophthalmology, University Clinic Reina Fabiola, Universidad Catolica de Cordoba, Oncativo 1248, Cordoba, 5000, Argentina. leandrocorrea50@hotmail.com.
authors.forename: Leandro J
authors.initials: LJ
authors.lastname: Correa
authors.affiliation: Department of Ophthalmology, University Clinic Reina Fabiola, Universidad Catolica de Cordoba, Oncativo 1248, Cordoba, 5000, Argentina. jpablomaccio@hotmail.com.
authors.forename: J Pablo
authors.initials: JP
authors.lastname: Maccio
authors.affiliation: Department of Ophthalmology, University Clinic Reina Fabiola, Universidad Catolica de Cordoba, Oncativo 1248, Cordoba, 5000, Argentina. gely_e@hotmail.com.
authors.forename: Evangelina
authors.initials: E
authors.lastname: Esposito
authors.affiliation: Department of Ophthalmology, University Clinic Reina Fabiola, Universidad Catolica de Cordoba, Oncativo 1248, Cordoba, 5000, Argentina. fitomonti@hotmail.com.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Monti
authors.affiliation: Department of Ophthalmology, University Clinic Reina Fabiola, Universidad Catolica de Cordoba, Oncativo 1248, Cordoba, 5000, Argentina. eugegonzalezc@hotmail.com.
authors.forename: M Eugenia
authors.initials: ME
authors.lastname: Gonzalez-Castellanos
authors.affiliation: Centro Medico de Patologia y Citopatologia, Cordoba, Argentina. marti@paradelo.com.ar.
authors.forename: Martin
authors.initials: M
authors.lastname: Paradelo
authors.affiliation: CIBICI-CONICET, Faculty of Chemical Sciences, Universidad Nacional de Cordoba, Cordoba, Argentina. hserra@mail.fcq.unc.edu.ar.
authors.forename: Horacio M
authors.initials: HM
authors.lastname: Serra
authors.affiliation: Department of Ophthalmology, University Clinic Reina Fabiola, Universidad Catolica de Cordoba, Oncativo 1248, Cordoba, 5000, Argentina. julioaurrets@gmail.com.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Urrets-Zavalia
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D001854:Bone Marrow Cells / Q000378:metabolism; D003229:Conjunctival Diseases / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D053668:Syndecan-1 / Q000378:metabolism
chemical_list: C508241:SDC1 protein, human; D053668:Syndecan-1