ABSTRACT
We report a 53-year-old female on chronic dialysis, presenting with weight loss, the development of big soft masses in the shoulders ("shoulder pads"), forearms and buttocks, macroglossia and rigidity of hands and lower limbs. Laboratory confirmed the presence of amyloidosis and myeloma with lambda chain restricted plasma cell infiltration of bone marrow. The diagnosis of multiple myeloma associated with primary amyloidosis in a patient with terminal renal failure, was reached.
Subject(s)
Female , Humans , Middle Aged , Amyloidosis/complications , Kidney Failure, Chronic/complications , Macroglossia/pathology , Multiple Myeloma/complications , Renal Insufficiency/complications , Amyloidosis/pathology , Fatal Outcome , ShoulderABSTRACT
Histoplasmosis is an endemic deep mycosis produced by Histoplasma capsulatum, a dimorphic fungus. It penetrates into the organism by inhalation and spreads by lymphatic or hematic route. We report a 57-year-old immunocompetent male presenting with an enlargement of the tongue that also exhibited white pseudomembranes. There were also nodular lesions in the dorsum of the tongue, separated by deep grooves. The pathological study revealed a chronic infammatory process with granulomas. The microbiological examination with the Giemsa technique showed multiple yeasts of 4-5 mm of diameter with a clear halo inside macrophages and epithelial cells, compatible with the parasitic phase of Histoplasma capsulatum. Serology was positive for the histoplasmine antigen. The patient was treated with Itraconazole 200 mg/day, experiencing 40 percent remission of lesions during the frst month of treatment.
Subject(s)
Humans , Male , Middle Aged , Histoplasmosis/complications , Macroglossia/microbiology , Argentina , Histoplasma , Histoplasmosis/pathology , Macroglossia/pathologyABSTRACT
A case of amyloidosis with macroglossia as a presenting feature is described. The patient was diagnosed to have multiple myeloma at least 1 1/2 year after amyloidosis was diagnosed.