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AL amyloidosis presenting with limb girdle myopathy
  1. Naveed Malek1,
  2. Dominic G O’Donovan2,
  3. Hadi Manji1
  1. 1 Department of Neurology, Ipswich Hospital NHS Trust, Ipswich, UK
  2. 2 Department of Neuropathology, Addenbrooke’s Hospital, Cambridge, UK
  1. Correspondence to Dr Naveed Malek, Department of Neurology, Ipswich Hospital NHS Trust, Ipswich IP4 5PD, UK; nmalek{at}


An elderly Caucasian man presented with a 10-month history of proximal myopathy and dysphagia. His serum creatine kinase (CK) was elevated at 877 U/L (normal 40–320) and electromyography confirmed a myopathic process. Blood and urine tests suggested myeloma; bone marrow examination showed 30% plasma cells and stained positive for amyloid. The muscle biopsy was initially reported as normal but in the light of the bone marrow report, the biopsy specimen was stained for amyloid, which was positive. We diagnosed systemic amyloidosis causing a myopathy and have started treatment for myeloma.

  • myopathy
  • amyloidosis

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  • Contributors All authors contributed equally to the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned. Externally peer reviewed by Satish Khadilkar, Mumbai, India and Michael Rose, London, UK.

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