Introduction:
Leukocyte chemotactic factor 2 amyloidosis (ALect2) is a recently recognized type of amyloidosis, common involvement of the kidneys with infrequent proteinuria and slow progression, rare involvement of the heart, relatively benign course and ethnic distribution are special characteristics that differentiate Alect2 from other types of amyloidosis (1).
Most cases of Alect2 were diagnosed in patients of Hispanic descent, also it was described to be common in Punjabi and native American ethnic groups (1,2).
Liver involvement is usually subclinical and likely to be underdiagnosed in Alect2, more commonly seen in autopsy studies. The presentation of hepatic disease is usually mild hepatocellular injury or isolated elevation of alkaline phosphatase and rarely severe disease (1).
Diagnosis of this disorder usually is made with special stain done on kidney or liver biopsies (3).
The management is usually supportive of the renal disease and there is no definite treatment, however, it is important to identify this type of amyloidosis to avoid unnecessary and sometimes toxic treatment if it is erroneously diagnosed as AL or AA which are more common amyloidosis subtypes (3).
We encountered a case of a Punjabi-descent man who presented with jaundice and hepatic encephalopathy and was diagnosed with liver biopsy.