Secondary amyloidosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Jesus Rosario Hernandez, M.D. [3]

Overview

Common physical examination findings of secondary amyloidosis include periorbital edema, pitting edema of the lower extremity, and signs of the underlying inflammatory disorder.

Physical Examination

• Physical examination of patients with secondary amyloidosis varies depending on the underlying cause. However, the presence of periorbital edema and lower extremity edema on physical examination is suggestive of the diagnosis. Hepatosplenomegaly, orthostatic hypotension, and diminished deep tendon reflexes may also be present.

Appearance of the Patient

• Patients with secondary amyloidosis usually appear normal.

Vital Signs

• Fever may be present due to underlying disorder.
• Tachycardia with regular pulse may be present.
• Orthostatic hypotension may be present.

Skin

• Skin examination of patients with secondary amyloidosis may show:
• Bruises

HEENT

• HEENT examination of patients with secondary amyloidosis may show:
• Macroglossia
• Jaw claudication

Neck

• Neck examination of patients with secondary amyloidosis is usually normal.
• Thyroid enlargement may be observed.

Lungs

• Pulmonary examination of patients with secondary amyloidosis is usually normal.

Heart

• Cardiovascular examination of patients with secondary amyloidosis is usually normal.

Abdomen

• Abdominal examination of patients with secondary amyloidosis may show hepatosplenomegaly.

Back

• Back examination of patients with secondary amyloidosis is usually normal.

Genitourinary

• Genitourinary examination of patients with secondary amyloidosis is usually normal.

Neuromuscular

• Neuromuscular examination of patients with secondary amyloidosis may show:
• Numbness of the fingers and toes
• Deep tendon reflexes may be abnormal.

Extremities

• Pitting edema of the lower extremities may be present.