Manifestations vary based on the type of amyloidosis and organs involved:
Cardiac involvement
- Restrictive cardiomyopathy with heart failure
- Conduction abnormalities and arrhythmias
- Orthostatic hypotension due to autonomic dysfunction
- Intolerance to standard heart failure medications
Renal involvement
- Proteinuria, often in nephrotic range
- Progressive renal impairment
- Higher risk with AL amyloidosis
Neurological involvement
- Peripheral sensorimotor neuropathy
- Autonomic neuropathy
- Carpal tunnel syndrome (often preceding diagnosis by years)
Gastrointestinal involvement
- Macroglossia
- GI bleeding
- Malabsorption, altered motility
- Hepatomegaly with abnormal LFTs
Skin manifestations
- Periorbital purpura ("raccoon eyes")
- Waxy papules/nodules
- Easy bruising
