Table 4.

Criteria for systemic involvement in AL amyloidosis with appropriate investigations

System involved	Criteria Biopsy of affected or alternate site AND	Tests required to demonstrate systemic involvement
Renal	Proteinuria of > 0.5 g/24 h (mainly albumin)	24 h urine protein
Cardiac involvement	Lab or clinical evidence of involvement Echocardiography showing more than 12 mm wall thickness in absence of other causes	Echo Troponin I N terminal pro brain natriuretic peptide ECG showing low voltage (< 5 mm) in all 12 leads
Liver	Liver span > 15 cm in absence of heart failure Alkaline phosphatase > 1.5 times the normal range of lab	CT scan or radionuclide imaging Alkaline phosphatase
Lung	Radiographic evidence of diffuse interstitial lung disease is taken as evidence of amyloidosis	CT scan/X ray
Gastro intestinal tract	Biopsy evidence with amyloid