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Table 1 Updated definition of organ involvement in AL amyloidosis

From: AL Amyloidosis

Involved organ or tissue Criteria
Kidney 24-hr urine protein > = 0.5 g/day, predominantly albumin
Heart NT-proBNP > 332 ng/l (in the absence of renal failure or atrial fibrillation) or mean wall thickness in diastole by echography > 12 mm, no other cardiac cause
Liver Total liver span > 15 cm in the absence of heart failure, or alkaline phosphatase > 1.5 times institutional upper limit of normal
Nerve Peripheral: Symmetric lower extremity sensorimotor peripheral neuropathy
  Autonomic: gastric-emptying disorder, pseudo-obstruction,voiding dysfunction not related to direct organ infiltration.
Gastro-intestinal tract Direct biopsy verification with symptoms
Lung Direct biopsy verification with symptoms
  Interstitial radiographic pattern
Soft tissues Tongue enlargement, arthropathy, claudication (presumed vascular amyloid), skin lesions, myopathy (by biopsy or pseudohypertrophy), lymph node (may be localized), carpal tunnel syndrome
  1. From Gertz et al. ( 3,4) with permission.