Unusual bleeding manifestations of amyloidosis in patients with multiple myeloma

Summary. We describe two patients who developed severe haemorrhagic complications. One manifested massive vaginal bleeding and the second haemopericardium with cardiac tamponade. In both cases histopathological examination showed subendothelial deposits of amyloid. Since other local and systemic causes of the haemorrhagic complications were excluded the bleeding was most probably due to amyloid angiopathy. Therefore, amyloid angiopathy should be considered in the differential diagnosis of bleeding in patients with amyloidosis associated with multiple myeloma.