Search

The authors report a case of amyloidosis AL associated with light lambda chain myeloma, mimicking giant cell temporal arteritis. The normality of inflammatory proteins, the primary resistance to corcicosteroids and the results of temporal artery biopsy (amyloid deposits without giant cell granuloma) excluded a diagnosis of giant cell arteritis associated with amyloidosis. The most probable mechanism was infiltration of branches of the external carotid artery. In patients with temporal arteritis, amyloidosis must be suspected and sought, particularly in case of monoclonal dysglobulinaemia or manifestations that are not typical of giant cell temporal arteritis. The prognosis of vascular amyloidosis seems to be more favourable than that of the classical visceral types. The primary amyloidosis of these patients must be treated with melphalan combined with prednisone and colchicine.

Amyloidosis of bone and bone marrow is rarely symptomatic and is generally limited to deposits diagnosed by histological examination. Four cases with lytic bone lesions are reported. In 2 cases, amyloidosis was associated with Waldenstroem's Macroglobulinemia, in one case with multiple myeloma and in 1 case with solitary plasmocytoma. These 4 cases are compared to 14 cases already published in the literature, including 2 cases of plasmocytic dyscrasias. The role of amyloidosis in the genesis of bone lesions is discussed.