Amyloidosis and vascular thrombosis

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Amyloidosis is a rare systemic disorder involving protein metabolism and extracellular deposition of fibrillary proteins, leading to organ dysfunction.
• Primary amyloidosis is common, but secondary amyloidosis can arise from plasma cell dyscrasias like multiple myeloma (MM).
• Approximately 10-15% of MM patients may develop amyloidosis affecting vital organs, typically associated with bleeding complications.

Observation:

• A 52-year-old Saudi female with secondary amyloidosis due to multiple myeloma presented with unusual thrombotic complications.
• The patient exhibited both venous and extensive arterial thrombosis.
• This presentation is contrary to the more common hemorrhagic complications associated with amyloidosis.

Findings:

• The case demonstrates that plasma cell dyscrasias, including amyloidosis and multiple myeloma, can manifest with thrombotic events.
• This contrasts with the generally accepted association of bleeding complications.
• The patient's presentation underscores a less common but significant clinical manifestation.

Implications:

• This case highlights the need to consider thrombotic complications in patients diagnosed with amyloidosis secondary to multiple myeloma.
• Clinicians should be vigilant for both bleeding and thrombotic events in these patients.
• Further research may elucidate the mechanisms underlying thrombotic tendencies in this patient population.