{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T02:40:10Z","timestamp":1787452810125,"version":"build-2736575974"},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T00:00:00Z","timestamp":1587081600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T00:00:00Z","timestamp":1587081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"The National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81800681"],"award-info":[{"award-number":["81800681"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Raccoon eyes or periorbital ecchymosis is caused by blood tracking into periorbital tissues, which is mostly recognized in injuries of head and neck, basal skull fractures, convexity fractures and facial fractures. It was also reported in systematic disorders, such as multiple myeloma, amyloidosis, Kaposi\u2019s sarcoma, migraine and neuroblastoma. However, it is unusual to see a patient showing periorbital purpura after kidney biopsy with no other ecchymosis. Here, we firstly reported this rare symptom after kidney biopsy in a patient who was finally diagnosed as immunoglobulin light chain (AL) amyloidosis.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 64-year old woman was admitted to our clinic with 1.5\u2009years history of sub-nephrotic proteinuria and slowly progressive deterioration of renal function. Laboratory -investigations revealed an M-peak in the \u03bb fraction of IgA and concentrations of serum free-light-chain (FLC) were 44.95\u2009mg\/L for \u03ba isotype and 173\u2009mg\/L for \u03bb isotype. Unexpectedly the patient showed periorbital purpura 24\u2009h later after kidney biopsy with no more other ecchymosis. Renal biopsy showed massively glomerulosclerosis, interstitial fibrosis with positively Congo red staining in mesangial areas. For fluorescent staining, the kidney tissue showed strongly \u03bb light-chain deposition. The fibrils (8-12\u2009nm in diameter) were confirmed by electron micrograph.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This case firstly reported this rare symptom after the kidney biopsy in a patient who was finally diagnosed as AL amyloidosis. And this unique sign of periorbital ecchymosis warrants more attention as an early cue of amyloidosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12882-020-01770-4","type":"journal-article","created":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T16:03:46Z","timestamp":1587139426000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A 64-year-old woman with raccoon eyes following kidney biopsy: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Shuqin","family":"Mei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changlin","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,17]]},"reference":[{"key":"1770_CR1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1080\/13506120903151775","volume":"16","author":"NH Heegaard","year":"2009","unstructured":"Heegaard NH. Beta(2)-microglobulin: from physiology to amyloidosis. Amyloid. 2009;16:151\u201373.","journal-title":"Amyloid"},{"key":"1770_CR2","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1159\/000456657","volume":"11","author":"J Nasiri","year":"2017","unstructured":"Nasiri J, Zamani F. Periorbital ecchymosis (raccoon eye) and orbital hematoma following endoscopic retrograde Cholangiopancreatography. Case Rep Gastroenterol. 2017;11:134\u201341.","journal-title":"Case Rep Gastroenterol"},{"key":"1770_CR3","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1016\/j.cell.2012.02.022","volume":"148","author":"D Eisenberg","year":"2012","unstructured":"Eisenberg D, Jucker M. The amyloid state of proteins in human diseases. Cell. 2012;148:1188\u2013203.","journal-title":"Cell."},{"key":"1770_CR4","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.2215\/CJN.10491012","volume":"8","author":"SM Said","year":"2013","unstructured":"Said SM, Sethi S, Valeri AM, et al. Renal amyloidosis: origin and clinicopathologic correlations of 474 recent cases. Clin J Am Soc Nephrol. 2013;8:1515\u201323.","journal-title":"Clin J Am Soc Nephrol"},{"key":"1770_CR5","doi-asserted-by":"publisher","first-page":"2406","DOI":"10.1056\/NEJMicm061510","volume":"356","author":"L Eder","year":"2007","unstructured":"Eder L, Bitterman H. Image in clinical medicine. Amyloid purpura. The New England J Med. 2007;356:2406.","journal-title":"The New England J Med"}],"container-title":["BMC Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-020-01770-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12882-020-01770-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-020-01770-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T23:13:53Z","timestamp":1618614833000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnephrol.biomedcentral.com\/articles\/10.1186\/s12882-020-01770-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,17]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1770"],"URL":"https:\/\/doi.org\/10.1186\/s12882-020-01770-4","relation":{},"ISSN":["1471-2369"],"issn-type":[{"value":"1471-2369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,17]]},"assertion":[{"value":"7 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not Applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient received all information regarding this case report. Written informed consent for publication in BMC Nephrology was obtained from the patient. A copy of the consent form is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}