Neuroarthropathy of the foot revealing primary systemic amyloidosis: case report and literature review.

Details

Serval ID
serval:BIB_E155C876BDF7
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Neuroarthropathy of the foot revealing primary systemic amyloidosis: case report and literature review.
Journal
Clinical Rheumatology
Author(s)
Andrei I.A., Kuntzer T., Lobrinus J.A., Jaccard A., Zufferey P.
ISSN
1434-9949 (Electronic)
ISSN-L
0770-3198
Publication state
Published
Issued date
2016
Volume
35
Number
2
Pages
535-539
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The aims of this review were to describe the case of a patient with debilitating neuroarthropathy of the ankles and feet and reveal a primary systemic (amyloid light chain, AL) amyloidosis and to review the relevant literature concerning the peripheral neuropathy and neuroarthropathy due to amyloidosis. We will emphasize the diagnostic pitfalls and discuss prognosis and treatments of both the peripheral neuropathy and the arthropathy related to AL amyloidosis. This is a descriptive case report of a patient with neuroarthropathy of the lower limbs due to AL amyloidosis. A review and discussion of relevant literature were conducted, based on a PubMed search from 1973 to December 2013. A 51-year-old female was diagnosed with AL amyloidosis after 20 months of investigation of small painful deformities of the feet. Chronic peripheral neuropathy occurs as a manifestation of AL amyloidosis in 25 % of cases. It may exceptionally be complicated by neuroarthropathy. In this case, the paucity of clinical and electrophysiological signs of the neuropathy delayed the diagnosis, leading to a severe arthropathy. The massive destruction of the joints dominated the clinical and the poor functional outcome. Diagnosis of AL amyloidosis should be considered in the presence of a mild peripheral neuropathy and a distal destructive and painless arthropathy. The two key diagnostic procedures are serum protein electrophoresis and nerve biopsy. Delay in treatment worsens the prognosis.
Pubmed
Web of science
Create date
25/09/2014 12:01
Last modification date
20/08/2019 17:05
Usage data