Figure 37

Symptoms of primary systemic amyloidosis in patients during an 11-year study at the Mayo Clinic. Weakness or fatigue and weight loss were the most frequent initial symptoms seen within 30 days of diagnosis. Weight loss occurred in more than half of patients. The median weight loss was 23 lb; five patients lost more than 100 lb each. Purpura, particularly in the periorbital and facial areas, was noted in about one sixth of patients. Gross bleeding was reported initially in only 3%. Skeletal pain was a major symptom in only 5% and usually was related to lytic lesions or fractures associated with multiple myeloma. Dyspnea, pedal edema, pares-thesias, light-headedness, and syncope were noted. (From Kyle and Gertz [5]; with permission.)

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