Oral manifestations of undiscovered systemic amyloidosis: a series of seven cases

Amyloidosis derived from abnormal extracellular fibril deposits may contribute to multiple organ dysfunctions. The recognition of amyloidosis-associated orofacial changes may be beneficial for the early diagnosis of this systemic pathology and the underlying diseases. This retrospective study aimed to determine the characteristics of orofacial amyloidosis to aid dentists in the recognition of this disease. Seven patients consulting the Department of Oral Medicine and Oral Surgery at Sahloul Hospital from January 2010 to January 2019 and diagnosed with systemic amyloidosis were included. The median age of onset, the most commonly affected sites, the predominant oral features of amyloidosis, and its complications were presented. The results of minor salivary gland and tongue biopsies were evaluated. Macroglossia was the most frequent oral lesion and it was associated with AL amyloidosis in 5 cases. Minor salivary gland biopsy was positive in four cases. We concluded that the dentist, especially the oral pathologist, has an important role in the evaluation of the local alterations that may reflect the patients´ systemic deterioration.