Cholestatic Jaundice Without Hepatomegaly as the Initial Manifestation of Hepatic Amyloid Light-Chain (AL) Amyloidosis: A Case of Rapid Multiorgan Failure

Abstract

Systemic amyloid light-chain (AL) amyloidosis is a rare plasma cell disorder characterized by extracellular deposition of misfolded immunoglobulin light chains, resulting in progressive organ dysfunction. Although hepatic involvement is recognized in AL amyloidosis, it is often clinically silent or presents with hepatomegaly (liver enlargement) and cholestatic liver enzyme abnormalities. Severe cholestatic jaundice as the initial and dominant manifestation is uncommon, particularly in the absence of hepatomegaly or radiographic biliary obstruction.