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DOI 10.1002/art.22184
Clinical Image: Bilateral black eyes (raccoon’s eyes) in AL amyloidosis
The patient, a 51-year-old woman, had noted the development of orbital signs ⬃1 year before she was diagnosed as having AL amyloidosis. Also known as raccoon’s eyes, this has been described to occur in association with a few diseases, primary amyloidosis and multiple myeloma among them. Raccoon’s eye is a consequence of vascular fragility induced by the deposition of amyloid and is sometimes associated with abnormal clotting, which can also occur in AL amyloidosis (1–3). 1. Loo H, Forman WB, Levine MR, Crum ED, Rasiga AL. Periorbital ecchymoses as the initial sign in multiple myeloma. Ann Ophthalmol 1982;14: 1066–8. 2. Dubrey SW, Cha K, Anderson J, Chamarthi B, Reisinger J, Skinner M, et al. The clinical features of immunoglobulin light-chain (AL) amyloidosis with heart involvement. QJM 1998;91:141–57. 3. Sucker C, Heltzel GR, Grabensee B, Stockschlaeder M, Scharf RE. Amyloidosis and bleeding: pathophysiology, diagnosis, and therapy. Am J Kidney Dis 2006;47:947–55.
Roge´rio Da Hora Passos, MD Adriano Pereira, MD Antonio Capone Neto, MD Andreza Feitosa Ribeiro, MD Jose Kutner, MD Hospital Israelita Albert Einstein Nelson Hamerschlak, MD Morton Scheinberg, MD, PhD Hospital Israelita Albert Einstein and Research Institute Sao Paulo, Brazil
