What is macroglossia?
Macroglossia means enlarged tongue. Most of the symptoms and signs of AL amyloidosis are non-specific and usually caused by several other common conditions. But macroglossia is one of the few rare complaints that are very suggestive of AL amyloidosis. Although only around 15% of patients with AL amyloidosis experience this problem, it is hardly ever caused by anything else, so it should certainly prompt doctors to investigate the possibility of AL amyloidosis. The whole tongue is usually diffusely enlarged and firm and there may be tooth indentations along the border. Symptoms associated with macroglossia in AL amyloidosis, including difficulty in swallowing, quite often gradually improve very slowly following remission of the underlying plasma cell dyscrasia, but there is seldom clear evidence of reduction in size. If macroglossia becomes marked and impairs swallowing, nutritional supplements may be recommended. At a very advanced stage, patients may require feeding through a tube to the stomach (percutaneous endoscopic gastroscopy (PEG) feeding). Surgery is not generally recommended to treat macroglossia as this may cause dangerous bleeding.
