Persistent Oropharyngeal Dysphagia Caused by Systemic Light Chain Amyloidosis Despite Hematologic Response: A Case Report

Authors

Haw-Wen Jeng, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
Tyng-Guey Wang, Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
Kuo-Chang Wei, Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, TaiwanFollow

Abstract

We report a case of a 44-year-old woman who developed progressive dysphagia and shoulder stiffness, ultimately leading to a diagnosis of multiple myeloma (MM) with systemic light-chain (AL) amyloidosis. Despite intensive systemic therapy for MM with good serological response and nine months of comprehensive swallowing rehabilitation, her tongue mobility remained severely restricted, with only minimal improvement in laryngeal elevation. Videofluoroscopic swallowing study (VFSS) confirmed poor tongue control, reduced laryngeal elevation, and penetration of thin liquids. She ultimately passed away despite hematologic control. This case underscores the profound impact of amyloid deposition on swallowing function, even in the context of medically controlled MM and AL amyloidosis combined with prolonged swallowing intervention. The suboptimal recovery suggests that amyloid infiltration may cause irreversible structural and neuropathic damage, limiting functional restoration. In such patients, dysphagia management may need to prioritize compensatory strategies and quality of life rather than curative rehabilitation.

Recommended Citation

Jeng, Haw-Wen; Wang, Tyng-Guey; and Wei, Kuo-Chang (2025) "Persistent Oropharyngeal Dysphagia Caused by Systemic Light Chain Amyloidosis Despite Hematologic Response: A Case Report," Rehabilitation Practice and Science: Vol. 2026: Iss. 1, Article 6.
DOI: https://doi.org/10.6315/3005-3846.2277
Available at: https://rps.researchcommons.org/journal/vol2026/iss1/6