A Case of Immunoglobulin Light Chain Hepatic Amyloidosis with Abdominal Hematoma

Hepatic amyloidosis belongs to a rare group of diseases that are difficult to diagnose, especially in elderly female patients. We report a case of AL-hepatic amyloidosis complicated by abdominal hematoma, which was misdiagnosed as clinical cirrhosis with hepatic sinusoidal obstruction syndrome. AL-amyloidosis is a group of diseases in which monoclonal immunoglobulin light chains (κ or λ type) are misfolded to form amyloid and deposited in tissues and organs, resulting in structural damage and organ dysfunction [1]. A 69-year-old female patient was evaluated for abdominal distension, jaundice, and generalized pruritus of 1 month duration. A CT scan was interpreted as abnormal hepatic density and enhancement, abdominopelvic fluid, and a pancreas-to-gastric hiatus hematoma (Figs. 1, 2 and 3). Congo red staining of a liver biopsy confirmed the diagnosis of AL-type hepatic amyloidosis (Fig. 4). This case suggests that the diagnosis of hepatic amyloidosis should be considered for elderly patients with unexplained hepatic decompensation and progressive elevation of bilirubin and definitively diagnosed by liver biopsy. …