Multiple Myeloma-Associated Amyloidosis We report a case of amyloidosis associated with

light chain multiple myeloma in a 42-year-old African American man. The patient initially had mild dyspepsia, which rapidly progressed to include anorexia, fulminant hepatic failure, and death within 9 weeks. This is only the fourth reported case of hepatic failure from myeloma-associated amyloidosis and the second reported case of light chain myeloma with amyloidosis resulting in a progressive clinical course of hepatic failure. Our patient was unique in that, despite severe disease, he had mild symptoms without laboratory abnormalities until 2 weeks prior to death.
Multiple myeloma is a malignant plasma cell disorder characterized by monoclonal immunoglobulin production with a peak incidence in the seventh decade of life. Most patients have bone pain, renal insufficiency, or anemia. Ten to fifteen percent of myeloma patients have extracellular deposition of amyloid in tissues resulting in amyloidosis. In these patients, symptoms will frequently manifest as nephrotic syndrome or heart failure. We report a case of multiple myeloma with amyloidosis manifesting as fulminant hepatic failure, resulting in refractory metabolic acidosis and fatal cardiac arrest.