{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T07:51:05Z","timestamp":1766044265903,"version":"3.48.0"},"reference-count":0,"publisher":"Jaypee Brothers Medical Publishing","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPI"],"published-print":{"date-parts":[[2025,11,10]]},"abstract":"<jats:p>Systemic amyloid light chain (AL) amyloidosis is a rare but potentially fatal disorder caused by \ndeposition of misfolded immunoglobulin light chains, often presenting with vague, nonspecific \nsymptoms that delay diagnosis. We report a diagnostically striking case of a 65-year-old male \npresenting with progressive tongue enlargement, periorbital purpura, submandibular swelling, \nand a prior history of carpal tunnel syndrome\u2014classic yet under-recognized features of AL \namyloidosis. Despite negative urine immunofixation and Bence-Jones proteinuria, the markedly \nelevated free lambda light chains and an abnormal kappa\/lambda ratio raised clinical suspicion. \nBone marrow biopsy revealed 25% plasma cells with lambda restriction and t(11;14) translocation, \nconfirming AL amyloidosis associated with plasma cell myeloma. Treatment with a daratumumab-, \nbortezomib-, and dexamethasone-based regimen led to dramatic clinical improvement. This case \nemphasizes the importance of recognizing subtle external manifestations as early diagnostic clues \nin AL amyloidosis, especially in the absence of classical laboratory markers. Timely recognition \ncan significantly improve outcomes in a condition where therapeutic delay can be devastating.<\/jats:p>","DOI":"10.59556\/japi.73.1236","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T07:48:52Z","timestamp":1766044132000},"page":"33-35","source":"Crossref","is-referenced-by-count":0,"title":["A Triad of Telltale Clues: Macroglossia Raccoon Eye and  Nerve Compression Unveil Amyloid Light Chain Amyloidosis"],"prefix":"10.59556","volume":"73","author":[{"given":"Fatema M","family":"Arsiwala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyotsna","family":"Oak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashutosh","family":"Tiwari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nupur","family":"Chaturvedi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2914","published-online":{"date-parts":[[2025,11,10]]},"container-title":["Journal of the Association of Physicians of India"],"original-title":[],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T07:48:55Z","timestamp":1766044135000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.japi.org\/article\/japi-73-11-s1-33"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,10]]},"references-count":0,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,10]]},"published-print":{"date-parts":[[2025,11,10]]}},"URL":"https:\/\/doi.org\/10.59556\/japi.73.1236","relation":{},"ISSN":["0004-5772"],"issn-type":[{"value":"0004-5772","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,10]]}}}