Introduction:
Leukocyte chemotactic factor 2 amyloidosis (ALect2) is a recently
recognized type of amyloidosis, common involvement of the kidneys with
infrequent proteinuria and slow progression, rare involvement of the
heart, relatively benign course and ethnic distribution are special
characteristics that differentiate Alect2 from other types of
amyloidosis (1).
Most cases of Alect2 were diagnosed in patients of Hispanic descent,
also it was described to be common in Punjabi and native American ethnic
groups (1,2).
Liver involvement is usually subclinical and likely to be underdiagnosed
in Alect2, more commonly seen in autopsy studies. The presentation of
hepatic disease is usually mild hepatocellular injury or isolated
elevation of alkaline phosphatase and rarely severe disease (1).
Diagnosis of this disorder usually is made with special stain done on
kidney or liver biopsies (3).
The management is usually supportive of the renal disease and there is
no definite treatment, however, it is important to identify this type of
amyloidosis to avoid unnecessary and sometimes toxic treatment if it is
erroneously diagnosed as AL or AA which are more common amyloidosis
subtypes (3).
We encountered a case of a Punjabi-descent man who presented with
jaundice and hepatic encephalopathy and was diagnosed with liver biopsy.