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Washington University Experience | PERIPHERAL NEUROPATHY | 14 AMYLOID NEUROPATHY | 9A0 Case 9 History
Case 9 History ---- The patient is a 65-year-old woman with a history of marginal zone lymphoma, diagnosed initially in 2008 at an outside hospital after she presented with anemia and splenomegaly. She underwent chemotherapy and then later experienced a recurrence in 2014, after bone marrow biopsy showed a “low grade B cell lymphoma consistent with the patient's prior history of marginal zone lymphoma.” She was treated with chemotherapy (including rituximab). In December 2017, she began having neurological symptoms that included paresthesias with arm and distal leg weakness. By summer of 2019, she had upper extremity numbness, dysarthria, and marked weakness in her fingers. Ultrasound showed enlargement of proximal portions of the median, ulnar and radial nerves without increased blood flow. Additionally, on physical exam, she was found to have fixed pupils, indicative of cranial nerve involvement. Operative procedure: Nerve biopsy of right ulnar nerve and muscle biopsy of right triceps.
