Macroglosia: amyloidosis misdiagnosed as angio-oedema.

To cite: Casadesus D, Araguez-Ancares N, Cotorruelo-Martinez A, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2015-210656 DESCRIPTION A 74-year-old Hispanic woman was admitted to our institution, with swelling of the tongue and lips. She had arrived in the USA 1 week before admission. In her native country, she had been diagnosed with angio-oedema and treated for more than 9 months, with no improvement. The records from the institution, located in the patient’s country, were never obtained. The patient’s daughter confirmed that amyloidosis was never considered and biopsy was never obtained, and that she had decided to bring her mother to the USA for better care. Physical examination of the patient’s head revealed waxy papules on both eyelids. Her tongue was mobile, soft and severely enlarged (figure 1). The lips and oral commissure had multiple ecchymosis. Skin examination showed multiple denuded bullae and petechia in dorsal hands, and bilateral groin and axilla (figure 2). The patient had multiple neck and axillary lymphadenopathies, and bilateral lower extremity oedema with multiple haematomas. Cardiopulmonary and abdominal examination was normal. A biopsy of the tongue showed a dense stromal collagenous matrix with deposition of amyloid, and