Publication Cover
Amyloid
The Journal of Protein Folding Disorders
Volume 22, 2015 - Issue 3
278
Views
2
CrossRef citations to date
0
Altmetric
Original Article

Vertebral compression fractures as the initial presentation of AL amyloidosis: case series and review of literature

, , , , , & show all
Pages 156-162 | Received 13 Feb 2015, Accepted 30 Mar 2015, Published online: 24 Jun 2015
 

Abstract

The clinical presentation of AL amyloidosis is highly variable. In this series, we describe five cases of AL amyloidosis with vertebral compression fractures as initial presentation. All five patients had evidence of bone marrow replacement on magnetic resonance imaging and bone marrow biopsies demonstrating diffuse interstitial amyloid deposition. Hepatomegaly and elevated liver enzymes, consistent with liver involvement with amyloidosis, were also seen in each case. All five patients responded well to anti-plasma cell chemotherapy, with normalization of serum free light chain levels, reduction in alkaline phosphatase and improvement in pain and functional status. Although rare, AL amyloidosis should be considered in the differential diagnosis of selected patients with spontaneous vertebral compression fractures. Moreover, there seems to be an association of vertebral compression fractures with liver involvement in AL amyloidosis.

Acknowledgements

We gratefully acknowledge our colleagues in the Amyloidosis Center, Cancer Clinical Trials Office, and Center for Cancer and Blood Disorders at Boston Medical Center who assisted with the multidisciplinary evaluation and treatment of the patients, and particularly the patients themselves who participated in this research study. We thank Dr Anita Deshpande for assistance with the images of the bone marrow biopsies.

Declaration of interest

The authors of this article have no pertinent conflicts of interest to disclose.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.