Renal amyloidosis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]
Overview
Physical examination of patients with renal amyloidosis is usually remarkable for swelling, hepatosplenomegaly, facial or neck purpura and macroglossia. Fatigue and unintentional weight loss, are common in patients with AL amyloidosis. Tachycardia/bradycardia depends on the accompanying complication. Pulmonary fine crackles, faint pulmonary auscultation, suggestive of pleural effusion, decreased tactile fremitus and dull percussion.
Physical Examination
Physical examination of patients with renal amyloidosis is usually remarkable for swelling, hepatosplenomegaly, facial or neck purpura and macroglossia. Fatigue and unintentional weight loss, are common in patients with AL amyloidosis. [1][2][3][4]
Appearance of the Patient
- Patient appears well in the earlier stages of the disease[5]
- Patient appears ill in the late stages of the disease due to multi-organ involvement[6]
Vital Signs
- Fever depends on accompanying infection
- Tachycardia/bradycardia depends on the accompanying complication[5]
- Tachypnea/bradypnea depends on the accompanying complication[6]
Skin
Eyes
Lungs
- Pulmonary fine crackles
- Faint pulmonary auscultation, suggestive of pleural effusion
- Decreased tactile fremitus
- Dull percussion[6]
Abdomen
- Abdominal distension
- Shifting dullness, suggestive of ascites
- Dull percussion
Extremities
- Pitting edema in lower extremities bilaterally
References
- ↑ Baker KR, Rice L (2012). "The amyloidoses: clinical features, diagnosis and treatment". Methodist Debakey Cardiovasc J. 8 (3): 3–7. PMC 3487569. PMID 23227278.
- ↑ Menke DM, Kyle RA, Fleming CR, Wolfe JT, Kurtin PJ, Oldenburg WA (August 1993). "Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis". Mayo Clin. Proc. 68 (8): 763–7. PMID 8331978.
- ↑ Kyle RA, Gertz MA (January 1995). "Primary systemic amyloidosis: clinical and laboratory features in 474 cases". Semin. Hematol. 32 (1): 45–59. PMID 7878478.
- ↑ Eder L, Bitterman H (June 2007). "Image in clinical medicine. Amyloid purpura". N. Engl. J. Med. 356 (23): 2406. doi:10.1056/NEJMicm061510. PMID 17554122.
- ↑ 5.0 5.1 5.2 Pinney JH, Whelan CJ, Petrie A, Dungu J, Banypersad SM, Sattianayagam P, Wechalekar A, Gibbs SD, Venner CP, Wassef N, McCarthy CA, Gilbertson JA, Rowczenio D, Hawkins PN, Gillmore JD, Lachmann HJ (April 2013). "Senile systemic amyloidosis: clinical features at presentation and outcome". J Am Heart Assoc. 2 (2): e000098. doi:10.1161/JAHA.113.000098. PMC 3647259. PMID 23608605.
- ↑ 6.0 6.1 6.2 Nishi S, Ubara Y, Utsunomiya Y, Okada K, Obata Y, Kai H, Kiyomoto H, Goto S, Konta T, Sasatomi Y, Sato Y, Nishino T, Tsuruya K, Furuichi K, Hoshino J, Watanabe Y, Kimura K, Matsuo S (June 2016). "Evidence-based clinical practice guidelines for nephrotic syndrome 2014". Clin. Exp. Nephrol. 20 (3): 342–70. doi:10.1007/s10157-015-1216-x. PMC 4891386. PMID 27099136.
- ↑ Eder L, Bitterman H (June 2007). "Image in clinical medicine. Amyloid purpura". N. Engl. J. Med. 356 (23): 2406. doi:10.1056/NEJMicm061510. PMID 17554122.