ABSTRACT
The thyroid gland is a common site for amyloid deposition in AL amyloidosis. However, it is not known how often there is associated hypothyroidism. Renal involvement is also common in AL amyloidosis and usually manifests as persistent nephrotic syndrome. This chapter aims to determine the prevalence of hypothyroidism in AL amyloidosis and to evaluate the impact of nephrotic syndrome on its occurrence. It explores the effect of treatment with high dose intravenous melphalan and autologous stem cell transplantation on AL amyloidosis-associated hypothyroidism. The prevalence of hypothyroidism in AL amyloidosis is substantially greater than that in the general adult population. There appears to be no relationship between the either the presence or the quantity of proteinuria and hypothyroidism. The absence of a relationship between thyroid function and proteinuria suggests that thyroid infiltration rather than urinary losses of thyroid hormone and/or binding proteins underlies the hypothyroidism in AL amyloidosis.
