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Joint Bone Spine
Volume 79, n° 2
pages 195-197 (mars 2012)
Doi : 10.1016/j.jbspin.2011.09.007
accepted : 28 September 2011
AL amyloidosis with temporal artery involvement simulates giant-cell arteritis

Alexandra Audemard a, 1, Jonathan Boutemy a, d, 1, Françoise Galateau-Salle b, d, 1, Margaret Macro c, 1, Boris Bienvenu a, d, 1,
a Department of Internal Medicine, CHU de Caen, 14000 Caen, France 
b Department of Pathology, CHU de Caen, 14000 Caen, France 
c Department of Haematology, CHU de Caen, 14000 Caen, France 
d Université de Caen Basse-Normandie, UFR de Médecine, 14000 Caen, France 

Corresponding author.

Light-chain (AL) amyloidosis may present with features suggesting vasculitis, including giant-cell arteritis (GCA). We describe a case of an 80-year-old man, who initially presented with bilateral jaw claudication, bi-temporal headache and arthralgia, however a temporal-artery biopsy then revealed AL amyloidosis. A diagnosis of AL amyloidosis complicating multiple myelome simulates GCA and polymyalgia rheumatica was established. The patient was successfully treated with melphalan and dexamethasone: the free kappa light chains decreased, the patient’s jaw claudication and headache disappeared. Then we discuss similarities between GCA and AL amyloidosis and potential confusion in diagnosis. We suggest that, in patients with clinical features of GCA without any temporal-artery typical findings, specimens are stained with Congo red, which then results in a different diagnosis and treatment.

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Keywords : AL amyloidosis, Primary amyloidosis, Giant-cell arteritis, Temporal arterial biopsy

1  All authors who contributed substantially to the manuscript have agreed with the data presented and its interpretations, and have given permission for its submission.

© 2011  Société française de rhumatologie@@#104156@@