In a 71-year-old woman with macroglossia and heart failure, a monoclon
al protein (kappa-light chains) was found in the serum. Congestive hea
rt failure was diagnosed on the basis of heart catheterization and ech
ocardiography. The tongue biopsy showed numerous amyloid fibrils, and
plasmacytosis was present in the bone marrow. AII these findings indic
ated a restrictive cardiomyopathy as part of a primary systemic amyloi
dosis.