What clinical history or findings make you more concerned for an amyloid-related neuropathy?

Many, including:

1. Presence of a monoclonal IgG or IgA protein on serum or urine protein immunofixation, especially lambda light chain, and especially if kappa to lambda light chain ratio is very low.
2. Unexplained autonomic dysfunction, especially orthostatic hypotension without compensatory tachycardia.
3. Severe bilateral carpal tunnel syndrome, without diabetes, or occupational history that increases risk of CTS.
4. Renal dysfunction, especially unexplained proteinuria.
5. Classic clinical clues for AL ...