{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:14:31Z","timestamp":1768000471981,"version":"3.49.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"35","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Rationale:<\/jats:title>\n            <jats:p>Amyloidosis accounts for 2% of head and neck tumors. Amyloidosis that develops in the head and neck region is localized amyloidosis. Multifocal amyloidosis in the head and neck region is extremely rare.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient concerns:<\/jats:title>\n            <jats:p>The patient presented to the clinic of otolaryngology with nasal obstruction, anosmia and left neck mass for several months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Diagnosis:<\/jats:title>\n            <jats:p>A left nasopharynx tumor was revealed under nasopharyngeal scope. Eosinophilic, proteinaceous material was revealed under a pathology scope in the nasopharynx tissue and neck tumor. Congo red staining demonstrated pale congophilic amorphous material with apple-green birefringence under cross-polarized light, and multifocal amyloidosis was diagnosed. Amyloidosis secondary to systemic lupus erythematosus (SLE) was confirmed after a series of investigations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>The patient underwent local excision for multifocal amyloidosis without following management. To control underlying SLE, the patient accepted steroid pulse therapy and immunosuppressants. The patient eventually achieved disease remission.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcomes:<\/jats:title>\n            <jats:p>During the 6 months of follow-up in the outpatient department of otolaryngology and rheumatology, complications, recurrence of nasopharyngeal amyloidosis, and SLE flare-up were not observed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Lessons:<\/jats:title>\n            <jats:p>Head and neck amyloidosis involving the nasopharynx is a rare presentation of this disease. Head and neck multifocal amyloidosis should be taken as a hint of systemic disease. In head and neck amyloidosis, a comprehensive survey should be performed to clarify the underlying disease predisposing to amyloidosis and organ involvement.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000016830","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T14:30:50Z","timestamp":1567089050000},"page":"e16830","source":"Crossref","is-referenced-by-count":6,"title":["Multifocal head and neck amyloidosis as a diagnostic clue of systemic lupus erythematosus (SLE)"],"prefix":"10.1097","volume":"98","author":[{"given":"Chih-Hao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Medical Education, E-Da Hospital, Kaohsiung"},{"name":"Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung,."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan-Hung","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung,."},{"name":"School of Medicine, Tzu Chi University, Hualien, Taiwan, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230914","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/nrrheum.2010.84","article-title":"Systemic amyloidosis: a challenge for the rheumatologist","volume":"6","author":"Perfetto","year":"2010","journal-title":"Nat Rev Rheumatol"},{"key":"R2-20230914","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1080\/13506129.2016.1257986","article-title":"Amyloid fibril proteins and amyloidosis: chemical identification and clinical classification International Society of Amyloidosis 2016 Nomenclature Guidelines","volume":"23","author":"Sipe","year":"2016","journal-title":"Amyloid"},{"key":"R3-20230914","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2500\/105065899781389768","article-title":"Primary amyloidosis presenting as a nasopharyngeal mass","volume":"13","author":"Lim","year":"1999","journal-title":"Am J Rhinol"},{"key":"R4-20230914","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1053\/ajot.2002.124195","article-title":"Nasopharyngeal amyloidosis","volume":"23","author":"Patel","year":"2002","journal-title":"Am J Otolaryngol"},{"key":"R5-20230914","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0030-6657(08)70333-0","article-title":"Head and neck amyloidosis","volume":"62","author":"Leszczy\u0144ska","year":"2008","journal-title":"Otolaryngol Pol"},{"key":"R6-20230914","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1002\/lary.26846","article-title":"Clinical characteristics of laryngeal versus nonlaryngeal amyloidosis","volume":"128","author":"Rudy","year":"2018","journal-title":"Laryngoscope"},{"key":"R7-20230914","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1200\/JCO.2010.32.2271","article-title":"Amyloidosis: pathogenesis and new therapeutic options","volume":"29","author":"Merlini","year":"2011","journal-title":"J Clin Oncol"},{"key":"R8-20230914","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1586\/1744666X.3.5.701","article-title":"Amyloid A amyloidosis and systemic lupus erythematosus","volume":"3","author":"D\u00fczg\u00fcn","year":"2007","journal-title":"Expert Rev Clin Immunol"},{"key":"R9-20230914","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1182\/blood.V79.7.1817.1817","article-title":"Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989","volume":"79","author":"Kyle","year":"1992","journal-title":"Blood"},{"key":"R10-20230914","first-page":"249","article-title":"Inflammatory reaction and laboratory tests: serum amyloid A (SAA) protein","volume":"38","author":"Yamada","year":"1990","journal-title":"Rinsho Byori"},{"key":"R11-20230914","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s10067-008-1025-7","article-title":"Proliferative lupus nephritis in a patient with systemic lupus erythematosus and longstanding secondary amyloid nephropathy","volume":"28","author":"Gomez-Puerta","year":"2009","journal-title":"Clin Rheumatol"},{"key":"R12-20230914","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1136\/ard.41.3.268","article-title":"Relationship between urinary sialylated saccharides, serum amyloid A protein, and C-reactive protein in rheumatoid arthritis and systemic lupus erythematosus","volume":"41","author":"Maury","year":"1982","journal-title":"Ann Rheum Dis"},{"key":"R13-20230914","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.amjoto.2006.08.009","article-title":"Localized amyloidosis masquerading as nasopharyngeal tumor: a review","volume":"28","author":"Panda","year":"2007","journal-title":"Am J Otolaryngol"},{"key":"R14-20230914","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0194-5998(00)70263-4","article-title":"Localized amyloid tumor of the nasopharynx","volume":"122","author":"Pitk\u00e4ranta","year":"2000","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R15-20230914","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/S1726-4901(09)70236-9","article-title":"Localized amyloid deposition in the nasopharynx and neck, mimicking nasopharyngeal carcinoma with neck metastasis","volume":"68","author":"Zhuang","year":"2005","journal-title":"J Chin Med Assoc"},{"key":"R16-20230914","doi-asserted-by":"crossref","first-page":"130","DOI":"10.2399\/jmu.2014003008","article-title":"Nasopharyngeal and laryngeal amyloidosis: a case report","volume":"4","author":"Yurtta\u015f","year":"2014","journal-title":"J Med Updat"},{"key":"R17-20230914","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1002\/lary.20106","article-title":"Laryngeal presentation of systemic apolipoprotein A-I-derived amyloidosis","volume":"119","author":"Hazenberg","year":"2009","journal-title":"Laryngoscope"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00005792-201908300-00020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T21:42:26Z","timestamp":1694727746000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00005792-201908300-00020"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":17,"journal-issue":{"issue":"35","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000016830","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}