Raccoon eye as the sole presenting sign of AL amyloidosis associated with a low-burden clonal plasma cell neoplasm.
Selin Kır, Filiz Vural, Nur Soyer
✦ AI-curated · Sources linked
Case in brief
A 60-year-old woman presented with recurrent periorbital purpura, known as 'raccoon eyes,' as the sole clinical manifestation. Diagnostic evaluation revealed elevated serum free lambda light chains, an abnormal kappa/lambda ratio, and an IgA lambda monoclonal gammopathy. Bone marrow analysis showed borderline plasma cell infiltration, and Congo red staining confirmed amyloid deposition. The case was classified as AL amyloidosis associated with a low-burden clonal plasma cell neoplasm.
What made this case unusual
The case is notable for presenting with raccoon eyes as the only clinical sign of AL amyloidosis, without typical features of multiple myeloma.
Diagnostic / clinical pearl
Clinicians should consider AL amyloidosis in patients presenting with periorbital purpura, even in the absence of classic multiple myeloma features.
Why it matters
Recognizing raccoon eyes as a potential indicator of underlying hematological disorders can facilitate earlier diagnosis and management of conditions like AL amyloidosis.