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Complications
By Mayo Clinic staffThe severity of amyloidosis depends on which organs the amyloid deposits affect. Potentially life-threatening situations include kidney failure and congestive heart failure:
- Kidney damage. When amyloidosis affects your kidneys, their filtering system is damaged, causing protein to leak from your blood into your urine. When large amounts of protein leave your bloodstream and appear in your urine, the loss of protein, specifically albumin, from your blood permits more fluid to leak out of your capillary blood vessels. This, along with retention of sodium, can cause your feet, ankles and calves to swell (edema). Ultimately, damage to the kidneys' filtering system inhibits your kidneys' ability to remove waste products from your body, which may progress to kidney failure.
- Heart damage. When amyloidosis affects your heart, a common symptom is shortness of breath, even with slight exertion. You may find it difficult to climb a flight of stairs or walk long distances without stopping to rest. When amyloid protein builds up in your heart, it reduces your heart's ability to fill with blood in between heartbeats. This means less blood is pumped with each beat. Your heart will have difficulty keeping up with your body's demand for blood during exertion. And when amyloidosis affects the electrical system of your heart, this may disturb your heart's rhythm.
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Nervous system damage. Another potential complication of amyloidosis is disruption of your nervous system function. This may include carpal tunnel syndrome — characterized by pain, numbness or tingling of the fingers. Disruption of another area of your nervous system might cause numbness or a lack of feeling in your toes or soles of your feet, or a burning sensation in these areas due to nerve infiltration.
If amyloid deposits affect the nerves that control your bowel function, you may experience periods of alternating constipation and diarrhea. Sometimes the condition affects nerves that control blood pressure, and you may experience dizziness or near fainting when standing too quickly as a result of a drop in your blood pressure.
- Seldin DC, et al. Amyloidosis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2863105. Accessed June 11, 2009.
- Amyloidosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec12/ch160/ch160a.html. Accessed June 12, 2009.
- Gertz MA, et al. Amyloidosis. Best Practice & Research Clinical Haematology. 2005;18:709.
- Amyloidosis and kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/Amyloidosis/. Accessed June 12, 2009.
- Gorevic PD. An overview of amyloidosis. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
- Dember LM. Modern treatment of amyloidosis: Unresolved questions. Journal of the American Society of Nephrology. 2009;20:469.
- Merlini G. Amyloidosis: Is a cure possible? Annals of Oncology. 2008;19(suppl):iv63.
- Jaccard A. High-dose melphalan versus melphalan plus dexamethasone for AL amyloidosis. New England Journal of Medicine. 2007;357:1083.
