A dilemma solved

BMJ Case Rep. 2009:2009:bcr09.2008.0921. doi: 10.1136/bcr.09.2008.0921. Epub 2009 Mar 5.

Abstract

A 63-year-old woman with severe symptomatic postural hypotension was treated unsuccessfully, and no underlying cause was found for 3 years until she was noted to have hypoalbuminaemia and proteinuria. A renal biopsy led to the diagnosis of amyloidosis. Despite being an established cause for autonomic neuropathy, amyloidosis was not suspected early enough. Although a diagnosis was reached and treatment started, the patient died as a complication of chemotherapy.