Warning Signs Of Amyloidosis

Enlarged Tongue

Individuals affected by amyloidosis may present with an enlarged tongue as an indicator of their disorder. The medical term that characterizes a swollen tongue that is large in terms of its proportion to other oral cavity structures is called macroglossia. Approximately nineteen percent of primary systemic amyloidosis patients experience macroglossia. An enlarged tongue can cause stridor or noisy breathing that is high-pitched, snoring, difficulties with eating, speaking, and abnormal development of the teeth and jaw. The tongue may project through any gaps present between the teeth and produce unique and abnormal indentations on the tongue surface. The enlarged tongue is caused by the disposition of amyloid in the subepithelial connective tissues of the tongue. Amyloid deposits are proteins that produce an antiparallel fashion of pleated sheets that make up non-branching, rigid fibers. These fibers resist enzyme actions of proteolysis or protein breakdown into amino acids. When these amyloids deposit in the tongue, they cause local oxidative stress and mechanical tissue disruption. Tissue damage occurs, and the ensuing inflammatory response causes the tongue to develop scar tissue and become enlarged.

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