Amyloidosis presents with diverse and nonspecific clinical manifestations, leading to frequent misdiagnosis or delayed diagnosis. Early diagnosis and aggressive intervention are critical for improving prognosis.

To enhance understanding of amyloidosis by analyzing the clinical features and outcomes of patients diagnosed at our center.

A retrospective analysis was conducted on clinical data from 69 patients diagnosed with amyloidosis at Yan'an Affiliated Hospital of Kunming Medical University between January 2015 and October 2023. Survival outcomes were collected via telephone follow-up. Patients were stratified into deceased and surviving groups based on disease-specific survival. Kaplan-Meier survival curves were generated, and between-group comparisons were performed using the Log-rank test.

A total of 69 patients with amyloidosis were included. Among them, 35 had cerebral amyloid angiopathy (CAA) with a median age at diagnosis of 72 (66, 80) years. The main clinical manifestations were intracerebral hemorrhage, cognitive impairment, or dementia. Six (17.1%) CAA patients died of intracerebral hemorrhage during initial hospitalization. Twelve patients had cutaneous amyloidosis with a median age at diagnosis of 67.0 (53.5, 75.5) years, presenting with miliary to mung bean-sized papules on the anterior tibia, extensor sides of the limbs, and back. Three patients had laryngeal amyloidosis, mainly presenting with hoarseness, throat discomfort, and a foreign body sensation in the larynx. Six patients had multiple myeloma (MM) complicated with light chain amyloidosis, with a mean age of 60.8±9.0 years and a median overall survival of 3.5 months. Five (83.3%) patients had involvement of two or more organs, and one (16.7%) had single-organ involvement. All six patients had edema, five (83.3%) had chest tightness and dyspnea, one (16.7%) had bone pain, and one (16.7%) had numbness in the extremities. One patient died of sudden cardiac death before treatment. Thirteen patients had systemic amyloidosis, including 12 with AL amyloidosis and one with AA amyloidosis. The 12 AL amyloidosis patients mainly presented with fatigue (10 cases, 83.3%), edema (9 cases, 75.0%), followed by foamy urine (6 cases, 50.0%) and chest tightness (6 cases, 50.0%). Other symptoms included dyspnea, weight loss, limb numbness, anorexia, and irregular bowel movements. Five (41.7%) had involvement of one organ, and seven (58.3%) had involvement of two or more organs. The most commonly affected organs were the kidneys (9 cases, 75.0%) and heart (8 cases, 66.7%), followed by the liver (3 cases, 25.0%). In AL amyloidosis patients, the 24-hour urine protein level was significantly higher in the deceased group than in the surviving group (P<0.05). Kaplan-Meier analysis showed a median survival time of 18.3 months for AL amyloidosis patients. Log-rank test indicated that patients with involvement of two or more organs had shorter survival times than those with single-organ involvement (χ²=4.757, P=0.029). The overall median survival time for MM patients with light chain amyloidosis was 3.5 months, with one patient dying during initial diagnosis. Among MM patients with light chain amyloidosis, those with anemia had significantly shorter survival times than those without anemia (χ²=5.000, P=0.025). Patients with heart function classⅣ had significantly shorter survival times than those with heart function classⅡ-Ⅲ (χ²=5.052, P=0.029). Untreated patients had significantly shorter survival times than treated patients (χ²=5.000, P=0.025).

The clinical manifestations of amyloidosis are highly diverse, and the prognosis varies significantly among different types. CAA predominantly affects the elderly and has a high mortality rate in the acute phase when complicated with intracerebral hemorrhage. Patients with MM complicated with light chain amyloidosis often present with symptoms related to amyloidosis involvement of vital organs such as the heart and kidneys. Anemia and heart function class Ⅳ may be adverse prognostic factors, while active treatment may improve prognosis. AL amyloidosis patients with involvement of multiple organs have a poor prognosis.