Clinical Report: Identifying Clinical Indicators of Pre-Amyloidosis

Overview

This study compares clinical indicators preceding the diagnosis of light chain (AL) and age-related transthyretin (ATTRwt) amyloidosis using electronic health records. Key findings reveal distinct symptom profiles and demographic differences between the two conditions.

Background

Amyloidosis is characterized by the deposition of misfolded proteins, leading to significant multiorgan involvement. Early diagnosis is crucial, particularly in AL amyloidosis, where treatment options exist but are not curative. Understanding the clinical indicators that precede diagnosis can facilitate better recognition and management of these conditions.

Data Highlights

Key Findings

• AL amyloidosis patients were younger (mean age 68) compared to ATTRwt patients (mean age 77).
• Heart failure was more prevalent in ATTRwt (72%) than in AL (45%).
• Chronic kidney disease was observed in 43% of AL patients versus 37% of ATTRwt patients.
• Gastrointestinal symptoms such as dysphagia and nausea/vomiting were more frequent in AL patients.
• Carpal tunnel syndrome was more prevalent in ATTRwt (28%) compared to AL (12%).

Clinical Implications

Recognizing the distinct symptom profiles associated with AL and ATTRwt amyloidosis can aid clinicians in making timely diagnoses.

Conclusion

The study highlights significant differences in clinical indicators between AL and ATTRwt amyloidosis.

Related Resources & Content

1. Blood Cancer Journal, 2021 -- Guidelines for the Diagnosis and Management of Immunoglobulin Light Chain Amyloidosis
2. Blood Cancer Journal, 2024 -- Symptom Onset and Overlap Before Diagnosing Light Chain (AL) Amyloidosis
3. Clinical Research in Cardiology -- Clinical Significance of Pericardial and Pleural Effusions in Individuals Diagnosed with Cardiac Amyloidosis
4. Blood Cancer Journal -- Disparities Among Racial Groups in Diagnosed Cases of Light Chain (AL) Amyloidosis
5. Transthyretin Cardiac Amyloidosis Evaluation and Management: 2025 ACC Concise Clinical Guidance | JACC
6. Daratumumab-Bortezomib-Cyclophosphamide-Dexamethasone in Newly Diagnosed Amyloidosis: ANDROMEDA Final Survival Analysis - PubMed
7. Musculoskeletal co‐morbidities in patients with transthyretin amyloid cardiomyopathy: a systematic review - PMC
8. Transthyretin Cardiac Amyloidosis Evaluation and Management: 2025 ACC Concise Clinical Guidance | JACC
9. Daratumumab-Bortezomib-Cyclophosphamide-Dexamethasone in Newly Diagnosed Amyloidosis: ANDROMEDA Final Survival Analysis - PubMed
10. Musculoskeletal co‐morbidities in patients with transthyretin amyloid cardiomyopathy: a systematic review - PMC