Primary Hepatic Amyloidosis Associated with Multiple Myeloma Causing Acute Liver Failure: A Case Report

Primary amyloidosis is the most prevalent type of amyloidosis and is usually due to plasma cell dyscrasia. It more commonly presents with renal and cardiac involvement and, although the liver is frequently involved in primary amyloidosis, it rarely causes clinically apparent disease. The most common form of hepatic involvement is hepatomegaly and mild elevation of alkaline phosphatase. Diagnosis requires tissue biopsy that demonstrates positive staining for Congo red and treatment is ideally a combination of chemotherapy and hematopoietic cell transplantation. The prognosis of hepatic amyloidosis associated with liver failure is poor. Here, we report a fatal case of primary amyloidosis in the setting of multiple myeloma in a 54-year-old man who presented with acute liver failure.