Hepatic Amyloidosis as a Rare Cause of Liver Failure: A Case Report

Amyloidosis is a systemic disease that results from the extracellular deposition of an abnormal protein called amyloid. The kidney and the heart are the most common organ affected by amyloidosis while in some cases liver involvement can be seen. Our patient is a 60-year-old African American male who presented to the emergency department because of multiple episodes of syncope over the past day. Chest x-ray and ultrasound chest were suggestive of pleural effusion for which thoracentesis was done. His hospital course was complicated with renal and liver failure. Computed tomography (CT) abdomen and pelvis was done which showed mild hepatomegaly. Liver biopsy was done which showed congo red stain positive for amyloid. The patient's clinical condition continued to worsen and he was started on hemodialysis. During hospital course, the patient developed liver failure. His family members opted for palliative care and the patient passed away during the same admission. Physicians need to be aware of the detrimental course and poor prognosis associated with hepatic and renal amyloidosis. High clinical suspicion is needed to make an early diagnosis and initiate prompt treatment. Although clinical, laboratory and radiological findings can help in suggesting amyloidosis, a tissue biopsy is needed to confirm the diagnosis of amyloidosis.