Among the following organs, which is the most common site of amyloid deposition in systemic amyloidosis?

Question

Accepted Answer

C. Kidney (glomeruli). ## Organ Tropism in Systemic Amyloidosis

**Key Point:** The kidney (specifically the glomeruli) is the most frequently affected organ in systemic amyloidosis, occurring in approximately 70% of patients with systemic disease.

### Renal Amyloidosis

#### Pathology
- Amyloid deposits in the **glomerular basement membrane** and **mesangium**
- Causes progressive glomerulonephritis leading to nephrotic syndrome
- Results in chronic kidney disease and eventual renal failure if untreated

#### Clinical Presentation
1. Nephrotic-range proteinuria (>3.5 g/day)
2. Hypoalbuminemia and edema
3. Hyperlipidemia
4. Progressive decline in GFR

### Organ Involvement Frequency in Systemic Amyloidosis

| Organ | Frequency (%) | Clinical Manifestation |
|---|---|---|
| **Kidney** | **70** | Nephrotic syndrome, CKD |
| Heart | 25 | Restrictive cardiomyopathy, arrhythmias |
| Liver | 20 | Hepatomegaly, rarely liver failure |
| Nervous system | 15 | Peripheral neuropathy, autonomic dysfunction |
| GI tract | 10 | Malabsorption, bleeding |

**High-Yield:** Renal involvement is the **most common** cause of morbidity and mortality in systemic amyloidosis. Cardiac involvement, though less frequent, is the most serious prognostically.

**Clinical Pearl:** Renal amyloidosis should be suspected in any patient with nephrotic syndrome + systemic features (hepatomegaly, cardiomegaly, neuropathy) or a history of chronic inflammation.

**Warning:** Do not confuse frequency of involvement with severity. Cardiac amyloidosis, though less common, carries the worst prognosis (median survival 6 months if untreated).

Answer

A. Liver

Answer

B. Nervous system (peripheral nerves)

Answer

D. Heart (myocardium)

Among the following organs, which is the most common site of amyloid deposition in systemic amyloidosis?

Explanation

Organ Tropism in Systemic Amyloidosis

Renal Amyloidosis

Pathology

Clinical Presentation

Organ Involvement Frequency in Systemic Amyloidosis

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Organ	Frequency (%)	Clinical Manifestation
Kidney	70	Nephrotic syndrome, CKD
Heart	25	Restrictive cardiomyopathy, arrhythmias
Liver	20	Hepatomegaly, rarely liver failure
Nervous system	15	Peripheral neuropathy, autonomic dysfunction
GI tract	10	Malabsorption, bleeding