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Amyloidosis presenting as macroglossia and restricted tongue movement Basim ES Dawoud Jennifer Taylor Senathirajah Ariyaratnam Michael N Pemberton Dental Update 2024 43:7, 707-709.
Authors
Basim ESDawoud
MBChB, BDS, MFDS RCS(Ed)
Dentally Qualified Medical Student, University of Leeds Medical School (basim.d@gmail.com)
Amyloidosis (AL) is a well recognized cause of macroglossia. A case of localized deposition of systemic amyloidosis secondary to multiple myeloma is reported in a 63-year-old female presenting with restricted tongue movement in the dental setting. Amyloidosis secondary to multiple myeloma is well documented in the literature, with amyloid deposits being found at various sites throughout the oral cavity and systemically. This case emphasizes the importance of a full oral soft tissue examination, including the need to examine mobility of the tissues, as it was the restricted movement of the tongue that ultimately alerted the clinician to the diagnosis. This report also highlights other dental implications of managing patients with multiple myeloma and amyloidosis.
CPD/Clinical Relevance: To provide an understanding of what multiple myeloma and amyloidosis are whilst, importantly, relating this to how these conditions can impact on routine dental treatment.
Article
Multiple Myeloma (MM) is a malignant neoplasm of the bone marrow characterized by proliferation of bone marrow plasma cells producing monoclonal immunoglobulins or light chains. These light chains are known as Bence-Jones proteins, which are excreted in the urine and are a diagnostic feature of multiple myeloma. This uncontrolled production can lead to renal failure, immunosuppression, skeletal destruction and anaemia of chronic disease. Prognosis is related to the staging of the disease. The disease predominantly affects older adults and, because of the multiple manifestations of this disease, patients can present with vague and confusing symptoms.1 It is thought that 5–15% of patients with multiple myeloma will develop amyloidosis. Amyloidosis is the localized and systemic extra-cellular deposition of insoluble fibrous protein aggregates known as amyloid. Amyloidosis can present intra-orally with various signs and symptoms including macroglossia.
A 63-year-old female was referred to the Oral Medicine Clinic at the University Dental Hospital of Manchester by her general dental practitioner (GDP).
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