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Myeloma associated amyloidosis presenting as subacute liver failure

¹ King’s College London, Institute of Liver Studies, King’s College Hospital, London, UK
² Department of Histopathology, King’s College Hospital

Correspondence to:
Correspondence to:
Dr T Cross
Institute of Liver Studies, Kings’ College Hospital, London SE5 9RS, UK; tjscross{at}hotmail.com

Multiple myeloma related amyloidosis is rare and its presentation with subacute liver failure (SALF) has not been reported. A case is described of a 46 year old woman presenting with a six week history of nausea, abdominal pain, and jaundice. Routine tests failed to establish a cause. Computed tomography showed a small volume liver consistent with SALF. Emergency liver transplantation was not undertaken because of the suspicion of underlying malignancy. At necropsy, liver biopsy showed amyloid deposition and bone marrow biopsy showed multiple myeloma. Thus, amyloidosis should be added to the list of potential causes of SALF.

Abbreviations: SALF, subacute liver failure; ALF, acute liver failure

Keywords: amyloidosis; multiple myeloma; acute liver failure; proteinuria