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Eyelid bleeding and atypical amyloidosis.
Gennady Landa1, Eyal Aloni, Asher Milshtein
1Department of Ophthalmology, Kaplan Medical Center, Rehovot 76100, Israel. genal@inter.net.il
American Journal of Ophthalmology
|September 15, 2004
Summary
This case report highlights atypical systemic amyloidosis presenting as recurrent eyelid and ear bleeding. A conjunctival biopsy proved crucial for diagnosis when other tests were negative.
Area of Science:
- Medicine
- Pathology
- Ophthalmology
Background:
- Systemic amyloidosis is a rare condition characterized by the deposition of amyloid protein in various organs.
- Atypical presentations can delay diagnosis and treatment, impacting patient outcomes.
Observation:
- A 52-year-old male with existing cardiac failure and hypertension presented with recurrent subcutaneous bleeding in the eyelids and auricles.
- Initial biopsies (bone marrow, salivary gland, fat, gastric mucosa, eyelids) were negative for Congo red staining.
Findings:
- Post-mortem examination, including conjunctival biopsy and cardiac muscle autopsy, revealed positive Congo red staining, confirming systemic amyloidosis.
- This indicates that amyloidosis can manifest with unusual symptoms and negative initial biopsies.
Implications:
- Ophthalmologists should consider amyloidosis in patients with periorbital bleeding, even with negative initial biopsies.
- Conjunctival biopsy may be a valuable diagnostic tool for primary systemic amyloidosis when other methods fail.