Amyloidosis physical examination: Difference between revisions

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{{Amyloidosis}}
{{Amyloidosis}}
{{CMG}} {{AE}} {{JH}}
{{CMG}}; {{AE}} {{JH}}
 
== Overview ==
== Overview ==
Common findings in amyloidosis include [[petechiae]], [[ecchymosis]], [[parotid gland enlargement]], increased [[intraocular pressure]], [[enlarged tongue]], [[hepatomegaly]], [[carpal tunnel syndrome]], and [[Raynaud's phenomenon]].
Common findings in amyloidosis include waxy thickening, [[easy bruising]], [[purpura]], macroglossia, [[parotid gland]] and [[submandibular gland]] enlargement, [[edema]], [[numbness]] and [[paresthesia]].


==Physical Examination==
==Physical Examination==
===Vitals===
[[Physical examination]] of patients with amyloidosis is usually remarkable for waxy thickening, [[easy bruising]], [[purpura]], [[macroglossia]], [[parotid gland]] and [[submandibular gland]] enlargement, [[edema]], [[numbness]] and [[paresthesia]].<ref name="pmid267192344">{{cite journal |vauthors=Wechalekar AD, Gillmore JD, Hawkins PN |title=Systemic amyloidosis |journal=Lancet |volume=387 |issue=10038 |pages=2641–2654 |date=June 2016 |pmid=26719234 |doi=10.1016/S0140-6736(15)01274-X |url=}}</ref><ref name="pmid14660909">{{cite journal |vauthors=Pribitkin E, Friedman O, O'Hara B, Cunnane MF, Levi D, Rosen M, Keane WM, Sataloff RT |title=Amyloidosis of the upper aerodigestive tract |journal=Laryngoscope |volume=113 |issue=12 |pages=2095–101 |date=December 2003 |pmid=14660909 |doi=10.1097/00005537-200312000-00007 |url=}}</ref><ref name="pmid23239211">{{cite journal |vauthors=Shin SC, Robinson-Papp J |title=Amyloid neuropathies |journal=Mt. Sinai J. Med. |volume=79 |issue=6 |pages=733–48 |date=2012 |pmid=23239211 |pmc=3531896 |doi=10.1002/msj.21352 |url=}}</ref><br />
===Appearance of the Patient===
*Patients with amyloidosis usually appear normal.
===Vital signs===
* [[Hypertension]]
* [[Hypertension]]
* [[Tachycardia]]
* [[Tachycardia]]
===Skin===
*Waxy thickening
*Easy bruising (ecchymoses)
*Subcutaneous [[nodules]] or [[plaques]]
*[[Purpura]]
* [[Petechiae]]
* Brittle nails
*[[Edema]]
*Diffuse or patchy [[alopecia]]
*Nail dystrophy
*Brittle nails


===Skin===
===HEENT===
* The most common skin findings are
*[[Macroglossia]]
** [[Petechiae]] (small red blood spots).
*[[Parotid gland]] enlargement
** [[Ecchymoses]] (small, flat blood spots that are round or irregular shape and bluish/purplish in colour)
*[[Submandibular gland]] enlargement
** Waxy papular nodules can be seen around the eye lids, neck and also in the groin.
*Peri-orbital [[purpura]]
** Brittle nails.
* Raised [[intraocular pressure]] may be seen.
** Edema due to [[heart failure]]
*Visual and hearing loss may be seen.
** Patches of [[hair loss]] can be seen.


===Head===
* [[Parotid gland]] enlargement
* Submandibular gland enlargement


====Ear====
<gallery>
<gallery>


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</gallery>
</gallery>


===Eyes===
===Neck===
* Raised intraocular pressure may be present.
* Neck examination of patients with amyloidosis is usually normal.
 
===Lungs===
*[[Hoarseness]]
*[[Stridor]]
*[[Dysphagia]]


===Throat===
===Heart===
* [[Enlarged tongue]]
*[[Arrhythmia]]


===Abdomen===
===Abdomen===
* [[Hepatomegaly]]
* [[Hepatomegaly]]
===Back===
* Back examination of patients with amyloidosis is usually normal.
===Genitourinary===
*[[Genitourinary]] examination of patients with amyloidosis is usually normal.
===Neuromuscular===
*[[Numbness]]
*[[Paresthesia]]
*Pain


===Extremities===
===Extremities===
*[[Edema]]
* [[Carpal tunnel syndrome]]
* [[Carpal tunnel syndrome]]
* [[Numbness]] of the fingers and toes
* [[Numbness]] of the fingers and toes
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===Macular Amyloidosis===
===Macular Amyloidosis===
<gallery widths=130px>
<gallery widths="130px">


291.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]
291.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]
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===Nodular Amyloidosis===
===Nodular Amyloidosis===
<gallery widths=130px>
<gallery widths="130px">


297.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]
297.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>]
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== References ==
== References ==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}
[[CME Category::Cardiology]]


[[Category:Disease]]
[[Category:Disease]]
[[Category:Rheumatology]]
[[Category:Rheumatology]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Mature chapter]]
[[Category:Metabolic disorders]]
[[Category:Inborn errors of metabolism]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
{{WH}}
{{WS}}

Latest revision as of 21:19, 17 December 2019

Amyloidosis Microchapters

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Patient Information

Overview

Historical Perspective

Classification

• Primary amyloidosis
• Secondary amyloidosis
• Familial amyloidosis
• Wild-type (senile) amyloidosis
• Cardiac amyloidosis
• Beta-2 microglobulin related amyloidosis
• Gelsolin related amyloidosis
• Lysozyme amyloid related amyloidosis
• Leucocyte cell-derived chemotaxin 2 related amyloidosis
• Fibrinogen A alpha-chain associated amyloidosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]

Overview

Common findings in amyloidosis include waxy thickening, easy bruising, purpura, macroglossia, parotid gland and submandibular gland enlargement, edema, numbness and paresthesia.

Physical Examination

Physical examination of patients with amyloidosis is usually remarkable for waxy thickening, easy bruising, purpura, macroglossia, parotid gland and submandibular gland enlargement, edema, numbness and paresthesia.[1][2][3]

Appearance of the Patient

  • Patients with amyloidosis usually appear normal.

Vital signs

Skin

HEENT


Neck

  • Neck examination of patients with amyloidosis is usually normal.

Lungs

Heart

Abdomen

Back

  • Back examination of patients with amyloidosis is usually normal.

Genitourinary

  • Genitourinary examination of patients with amyloidosis is usually normal.

Neuromuscular

Extremities

Macular Amyloidosis

Nodular Amyloidosis

References

  1. ↑ Wechalekar AD, Gillmore JD, Hawkins PN (June 2016). "Systemic amyloidosis". Lancet. 387 (10038): 2641–2654. doi:10.1016/S0140-6736(15)01274-X. PMID 26719234.
  2. ↑ Pribitkin E, Friedman O, O'Hara B, Cunnane MF, Levi D, Rosen M, Keane WM, Sataloff RT (December 2003). "Amyloidosis of the upper aerodigestive tract". Laryngoscope. 113 (12): 2095–101. doi:10.1097/00005537-200312000-00007. PMID 14660909.
  3. ↑ Shin SC, Robinson-Papp J (2012). "Amyloid neuropathies". Mt. Sinai J. Med. 79 (6): 733–48. doi:10.1002/msj.21352. PMC 3531896. PMID 23239211.

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