{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:25:43Z","timestamp":1766049943988,"version":"3.48.0"},"reference-count":16,"publisher":"Pensoft Publishers","issue":"6","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>\n                    <jats:bold>Abstract<\/jats:bold>\n                  <\/jats:p>\n                  <jats:p>Light chain amyloidosis (AL) is a rare systemic disorder caused by the accumulation of immunoglobulin light chains in various organs, most notably the heart. Its clinical presentation is often nonspecific, leading to delayed diagnosis and poor prognosis. We report the case of a 71-year-old woman who presented with macroglossia and periorbital ecchymosis, symptoms that persisted for six years before diagnosis, along with dyspnea on exertion for the past year. Comprehensive evaluation revealed AL amyloidosis with significant cardiac involvement, evidenced by echocardiographic findings of concentric ventricular wall thickening and diastolic dysfunction consistent with restrictive cardiomyopathy. Laboratory workup confirmed elevated serum free light chains (FLC), and histopathology demonstrated the presence of amyloid deposits confirming the diagnosis. This case acknowledges cardiac AL amyloidosis as a rare cause of cardiac failure with preserved ejection fraction, often accompanied by systemic manifestations of the disease such as macroglossia and periorbital ecchymosis, and highlights the critical need for high clinical suspicion and early recognition of cardiac involvement in AL patients.<\/jats:p>","DOI":"10.3897\/folmed.67.e145063","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:19:34Z","timestamp":1766049574000},"source":"Crossref","is-referenced-by-count":0,"title":["Echoes of a hidden killer: a case of oral and cardiac amyloidosis"],"prefix":"10.3897","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0724-2890","authenticated-orcid":true,"given":"Areti","family":"Kalfoutzou","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, 251 Air Force General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0272-3259","authenticated-orcid":true,"given":"Adam","family":"Mylonakis","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0959-0094","authenticated-orcid":true,"given":"Margaritis","family":"Tsantopoulos","sequence":"additional","affiliation":[{"name":"Department of Pathology, 251 Air Force General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9171-3453","authenticated-orcid":true,"given":"Nikolaos","family":"Chaleplidis","sequence":"additional","affiliation":[{"name":"Department of Pathology, 251 Air Force General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8293-7283","authenticated-orcid":true,"given":"Christos","family":"Piperis","sequence":"additional","affiliation":[{"name":"Georgios Gennimatas Peripheral General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1996-4090","authenticated-orcid":true,"given":"Maria","family":"Dimitrakoudi","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7982-8916","authenticated-orcid":true,"given":"Konstantinos","family":"Kounouklas","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, 251 Air Force General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleftheria","family":"Bagiokou","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, 251 Air Force General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0491-1383","authenticated-orcid":true,"given":"Eleni","family":"Mostratou","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, 251 Air Force General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"145063_B1","doi-asserted-by":"crossref","unstructured":"1. Palladini G, Merlini G. What is new in diagnosis and management of light chain amyloidosis? Blood 2016; 128(2):159\u201368.","DOI":"10.1182\/blood-2016-01-629790"},{"key":"145063_B2","doi-asserted-by":"crossref","unstructured":"2. Mankad AK, Sesay I, Shah KB. Light-chain cardiac amyloidosis. Curr Probl Cancer 2017; 41(2):144\u201356.","DOI":"10.1016\/j.currproblcancer.2016.11.004"},{"key":"145063_B3","doi-asserted-by":"crossref","unstructured":"3. Taylor MS, Sidiqi H, Hare J, et al. Current approaches to the diagnosis and management of amyloidosis. Intern Med J 2022; 52(12):2046\u201367.","DOI":"10.1111\/imj.15974"},{"key":"145063_B4","doi-asserted-by":"crossref","unstructured":"4. Adam RD, Coriu D, Jercan A, et al. Progress and challenges in the treatment of cardiac amyloidosis: a review of the literature. ESC Heart Fail 2021; 8(4):2380\u201396.","DOI":"10.1002\/ehf2.13443"},{"key":"145063_B5","doi-asserted-by":"crossref","unstructured":"5. Barge-Caballero G, Barge-Caballero E, L\u00f3pez-P\u00e9rez M, et al. Cardiac amyloidosis: Description of a series of 143 cases. Med Cl\u00ednica Engl Ed 2022; 159(5):207\u201313.","DOI":"10.1016\/j.medcle.2022.08.001"},{"key":"145063_B6","doi-asserted-by":"crossref","unstructured":"6. Maurer MS, Elliott P, Comenzo R, et al. Addressing common questions encountered in the diagnosis and management of cardiac amyloidosis. Circulation 2017; 135(14):1357\u201377.","DOI":"10.1161\/CIRCULATIONAHA.116.024438"},{"key":"145063_B7","doi-asserted-by":"crossref","unstructured":"7. Rubin J, Maurer MS. Cardiac amyloidosis: overlooked, underappreciated, and treatable. Annu Rev Med 2020; 71(1):203\u201319.","DOI":"10.1146\/annurev-med-052918-020140"},{"key":"145063_B8","doi-asserted-by":"crossref","unstructured":"8. Milani P, Merlini G, Palladini G. Light chain amyloidosis. Mediterr J Hematol Infect Dis 2018; 10(1):e2018022.","DOI":"10.4084\/mjhid.2018.022"},{"key":"145063_B9","doi-asserted-by":"crossref","unstructured":"9. Gertz MA, Dispenzieri A, Sher T. Pathophysiology and treatment of cardiac amyloidosis. Nat Rev Cardiol 2015; 12(2):91\u2013102.","DOI":"10.1038\/nrcardio.2014.165"},{"key":"145063_B10","unstructured":"10. Mugnai G, Cicoira M, Rossi A, et al. Syncope in cardiac amyloidosis and chronic ischemic heart disease: A case report. Exp Clin Cardiol 2011;16(2):51."},{"key":"145063_B11","doi-asserted-by":"crossref","unstructured":"11. Diomede L, Romeo M, Rognoni P, et al. Cardiac light chain amyloidosis: the role of metal ions in oxidative stress and mitochondrial damage. Antioxid Redox Signal 2017; 27(9):567\u201382.","DOI":"10.1089\/ars.2016.6848"},{"key":"145063_B12","doi-asserted-by":"crossref","unstructured":"12. Lv P, Li Y, Wu L, et al. Case report: systemic amyloidosis involving the heart and skeletal muscle. Front Cardiovasc Med 2022; 9:816236.","DOI":"10.3389\/fcvm.2022.816236"},{"key":"145063_B13","doi-asserted-by":"crossref","unstructured":"13. John S, Subba P, Aramugam A, et al. A serious warning: A case report on localized amyloidosis of the oral cavity. Indian J Pathol Microbiol 2025; 68(1):212\u20135. Available from: https:\/\/journals.lww.com\/10.4103\/ijpm.ijpm_720_23","DOI":"10.4103\/ijpm.ijpm_720_23"},{"key":"145063_B14","doi-asserted-by":"crossref","unstructured":"14. Indu S, Roy I, Tewari R, et al. Oral amyloidosis: A case report and diagnostic algorithm. J Oral Maxillofac Pathol 2021; 25(3):559.","DOI":"10.4103\/jomfp.JOMFP_227_20"},{"key":"145063_B15","doi-asserted-by":"crossref","unstructured":"15. Tsai SB, Seldin DC, Wu H, et al. Myocardial infarction with \u201cclean coronaries\u201d caused by amyloid light-chain AL amyloidosis: a case report and literature review. 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