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Article: Volume 43 Number 7 Page 641 - September 2016

  Dental Update 437: 641-647  Read article

Oral medicine:  Amyloidosis Presenting as Macroglossia and Restricted Tongue Movement

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Abstract: 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.

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.

Author notes: Basim ES Dawoud, BDS, MFDS RCS(Ed), Dentally Qualified Medical Student, University of Leeds Medical School (basim.d@gmail.com), Jennifer Taylor, BDS MFDS RCS(Ed), MBChB, Locum Consultant Oral Medicine, Oral Medicine Department, Senathirajah Ariyaratnam, BDS, MDS, FDS RCS, Clinical Lecturer/Specialist in Oral Medicine and Oral Surgery, Oral Medicine Department and Michael N Pemberton, BDS, MBChB, FDS RCS(Ed), Consultant in Oral Medicine, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK.

Objective: To assist GDPs in the detection of early warning signs of multiple myeloma and amyloidosis to help improve the prognosis of patients with these conditions.