Myeloma and severe cholestasis

Amyloidosis is a frequent complication of multiple myeloma. Liver involveme nt is common in amyloidosis. Hepatic dysfunction and liver chemistry abnorm alities are often mild or absent and obstructive jaundice is rare. We repor t on a 44-year-old patient with multiple myeloma and rapidly deteriorating liver involvement with severe intrahepatic cholestasis. Autopsy showed wide spread amyloidosis primarily involving the liver. This unusual cholestatic manifestation of hepatic amyloidosis has an uniformly poor prognosis, with death occurring within a few months. We discuss the clinical and pathologic aspects.