Medical education Snapshot
Hematologic diseases
Volume 206 - Issue 9

Raccoon eyes in systemic light chain amyloidosis

Authors:  Cecily J Forsyth and Campbell R Tiley

Med J Aust 2017; 206 (9): 384. || doi: 10.5694/mja16.00848
Published online: 15 May 2017
A 51-year-old man presented with a 3-year history of recurrent upper eyelid haematomas
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A 51-year-old man presented with a 3-year history of recurrent upper eyelid haematomas. He had a low level IgA lambda paraprotein in blood, Bence–Jones protein and a lambda predominance on serum free light chain ratio. Biopsies of his eyelids showed vascular infiltration by amyloid fibrils (lambda light chains) establishing a diagnosis of light chain (AL) amyloidosis. The patient had cutaneous involvement only at diagnosis. He underwent an autologous stem cell transplant 4 years after the initial presentation, at which time there was evidence of early cardiac involvement by AL amyloidosis manifest by increased B-type natriuretic peptide and confirmed on cardiac magnetic resonance imaging. While thrombocytopenic during his transplant, the patient developed bilateral periorbital haematomas, which resolved with platelet engraftment.

Authors

  • Cecily J Forsyth1,2
  • Campbell R Tiley3
  • 1. Wyong Public Hospital, Wyong, NSW
  • 2. Jarrett Street Specialist Centre, Gosford, NSW
  • 3. Gosford Hospital, Gosford, NSW

Correspondence: cecily.forsyth@healthemail.com.au

Competing interests

No relevant disclosures.
View this article on Wiley Online Library