Table 1.

Disease changes and treatment procedures

Time node	Clinical manifestation	Examination and treatment
Feb. 12th 2023	Upper abdominal pain for 17 days	Hb 71 → 45g/L, CT showed retroperitoneal hematoma with no contrast medium leakage
Feb. 13th 2023	Fever and jaundice	Blood transfusion, anti-infection
Feb. 18th 2023	None	CT roughly the same as before
Feb. 25th 2023	Infection state almost controlled	Deventilation and extubation
Feb. 27th 2023	Gastric tube drainage with a intermittent bright red - reddish-brown fluid	Fasting for solids and liquids
Feb. 28th 2023	Same as above	Arrived at the emergency department of PUMCH
Mar. 1st 2023	Low fever, abdominal pain	Admitted to the emergency generalized ward, plasma infusion, anti-infection, cooling, pain relief, rehydration,
Mar. 2nd 2023	Reddish brown of gastric tube drainage	Transferred to EICU and red blood cells, plasma, human fibrinogen, PCCs, vitamin K1 were infused
Mar. 4th 2023	Symptoms were improved	Back to the general ward
Mar. 8th to 24th 2023	Transit to liquid diet without discomfort gradually	Myocardium and abdominal wall biopsy pathology λ + , congo red + , consistent with amyloidosis (AL-λ type)
Mar. 24th 2023	Same as above	Transferred to the hematology department, developed fever again
Mar. 28th 2023	Same as above	Comprehensive discussion by the professional team
Mar. 29th 2023	Same as above	Daretumab + bortezomib + dexamethasone