Systemic amyloidosis: A big masquerade of clinical symptoms with catastrophic consequences

A case of a 52-year-old woman presented with non-specific symptoms: generalised weakness, loss of appetite and left leg pain of about a week duration. She later developed nephrotic syndrome, cardiomegaly with arrhythmias, adrenal insufficiency, cutaneous amyloid, with consolidation on chest X-ray and hepatomegaly. She had a renal biopsy that revealed renal amyloidosis. She was treated with thalidomide, bortezomib, methylprednisolone, ranitidine and allopurinol without significant improvement. Amyloidosis is a rare disease that requires a high index of suspicion. She may have responded if she had been diagnosed early, and hence, early diagnosis is a key in successful management.