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T1 Age 2 13 62-year-old T2 Sex 14 18 male T3 Activity 19 28 presented E1 Activity:T3 T4 Duration 36 50 15-day history E2 Duration:T4 T5 Sign_symptom 54 61 dyspnea E3 Sign_symptom:T5 T6 Detailed_description 65 73 exertion T7 Sign_symptom 112 117 edema E4 Sign_symptom:T7 T8 Biological_structure 91 111 both lower extremity R2 MODIFY Arg1:T8 Arg2:E4 T9 Outcome 2945 2949 died E5 Outcome:T9 T10 Nonbiological_location 2953 2957 home R3 MODIFY Arg1:T10 Arg2:E5 T11 Date 2958 2972 after 3 months E6 Date:T11 T12 Medication 2724 2733 melphalan E7 Medication:T12 T13 Medication 2693 2705 chemotherapy E8 Medication:T13 T14 Medication 2735 2748 dexamethasone E9 Medication:T14 T15 Medication 2766 2778 lenalidomide E10 Medication:T15 R4 SUB_PROCEDURE Arg1:E7 Arg2:E8 R5 SUB_PROCEDURE Arg1:E9 Arg2:E8 R6 SUB_PROCEDURE Arg1:E10 Arg2:E8 T16 Therapeutic_procedure 2784 2802 supportive therapy E11 Therapeutic_procedure:T16 T17 Medication 2813 2828 montmorillonite E12 Medication:T17 T18 Medication 2863 2873 furosemide E13 Medication:T18 R7 SUB_PROCEDURE Arg1:E12 Arg2:E11 R8 SUB_PROCEDURE Arg1:E13 Arg2:E11 T19 Sign_symptom 2929 2940 deteriorate E14 Sign_symptom:T19 T20 Dosage 2854 2862 low-dose R9 MODIFY Arg1:T20 Arg2:E13 T21 Sign_symptom 2887 2902 fluid retention E15 Sign_symptom:T21 T22 Sign_symptom 2841 2849 diarrhea E16 Sign_symptom:T22 T23 Disease_disorder 2653 2667 AL amyloidosis E17 Disease_disorder:T23 #1 AnnotatorNotes E17 immunoglobulin light chain amyloidosis T24 Sign_symptom 178 186 bloating E18 Sign_symptom:T24 T25 Sign_symptom 191 200 tasteless E19 Sign_symptom:T25 T26 Biological_structure 168 177 abdominal R10 MODIFY Arg1:T26 Arg2:E18 T27 Duration 201 211 for a year E20 Duration:T27 T28 Sign_symptom 233 244 weight loss E21 Sign_symptom:T28 T29 Quantitative_concept 263 274 up to 20 kg R11 MODIFY Arg1:T29 Arg2:E21 T30 Duration 277 299 Over the past 6 months E22 Duration:T30 T31 Disease_disorder 316 340 multiple system disorder E23 Disease_disorder:T31 T32 Sign_symptom 366 378 paresthesias E24 Sign_symptom:T32 T33 Detailed_description 357 365 painless R12 MODIFY Arg1:T33 Arg2:E24 T34 Biological_structure 386 397 lower limbs R13 MODIFY Arg1:T34 Arg2:E24 T35 Disease_disorder 399 419 erectile dysfunction E25 Disease_disorder:T35 T36 Sign_symptom 433 441 diarrhea E26 Sign_symptom:T36 T37 Disease_disorder 425 441 chronic diarrhea E27 Disease_disorder:T37 T38 Detailed_description 425 432 chronic R14 MODIFY Arg1:T38 Arg2:E26 T39 Diagnostic_procedure 461 476 stool frequency E28 Diagnostic_procedure:T39 T40 Quantitative_concept 480 503 up to ten times per day R15 MODIFY Arg1:T40 Arg2:E28 T41 Sign_symptom 553 557 pain E29 Sign_symptom:T41 A1 POLARITY E29 NEG T42 Biological_structure 543 552 abdominal R16 MODIFY Arg1:T42 Arg2:E29 T43 Family_history 686 717 family history was unremarkable T44 Diagnostic_procedure 748 762 blood pressure E30 Diagnostic_procedure:T44 T45 Lab_value 767 777 82/56 mmHg R17 MODIFY Arg1:T45 Arg2:E30 T46 Diagnostic_procedure 782 792 heart rate E31 Diagnostic_procedure:T46 T47 Lab_value 797 803 52 bpm R18 MODIFY Arg1:T47 Arg2:E31 T48 Sign_symptom 832 842 distention E32 Sign_symptom:T48 T49 Biological_structure 817 831 jugular venous R19 MODIFY Arg1:T49 Arg2:E32 T50 Severity 805 816 Significant R20 MODIFY Arg1:T50 Arg2:E32 T51 Sign_symptom 853 865 hepatomegaly E33 Sign_symptom:T51 T52 Severity 844 852 moderate R21 MODIFY Arg1:T52 Arg2:E33 T53 Sign_symptom 887 892 edema E34 Sign_symptom:T53 T54 Biological_structure 871 886 lower extremity R22 MODIFY Arg1:T54 Arg2:E34 T55 Diagnostic_procedure 614 620 biopsy E35 Diagnostic_procedure:T55 T56 Biological_structure 595 602 stomach T57 Biological_structure 607 613 rectum R23 MODIFY Arg1:T57 Arg2:E35 R24 MODIFY Arg1:T56 Arg2:E35 T58 Diagnostic_procedure 658 680 amyloid fibril protein E36 Diagnostic_procedure:T58 A2 POLARITY E36 NEG T59 Diagnostic_procedure 2584 2590 biopsy E37 Diagnostic_procedure:T59 T60 Biological_structure 2577 2583 Rectum R25 MODIFY Arg1:T60 Arg2:E37 T61 Sign_symptom 2609 2619 infiltrate E38 Sign_symptom:T61 T62 Detailed_description 2601 2608 amyloid R26 MODIFY Arg1:T62 Arg2:E38 T63 Diagnostic_procedure 1323 1338 laboratory data E39 Diagnostic_procedure:T63 T64 Diagnostic_procedure 1353 1369 full blood count E40 Diagnostic_procedure:T64 T65 Diagnostic_procedure 1371 1383 transaminase E41 Diagnostic_procedure:T65 T66 Diagnostic_procedure 1385 1395 creatinine E42 Diagnostic_procedure:T66 T67 Diagnostic_procedure 1397 1409 electrolytes E43 Diagnostic_procedure:T67 T68 Diagnostic_procedure 1411 1427 cardiac troponin E44 Diagnostic_procedure:T68 T69 Diagnostic_procedure 1433 1449 thyroid function E45 Diagnostic_procedure:T69 R27 SUB_PROCEDURE Arg1:E40 Arg2:E39 R28 SUB_PROCEDURE Arg1:E41 Arg2:E39 R29 SUB_PROCEDURE Arg1:E42 Arg2:E39 R30 SUB_PROCEDURE Arg1:E43 Arg2:E39 R31 SUB_PROCEDURE Arg1:E44 Arg2:E39 R32 SUB_PROCEDURE Arg1:E45 Arg2:E39 T70 Lab_value 1455 1461 normal E46 Lab_value:T70 T71 Lab_value 1465 1473 negative E47 Lab_value:T71 R33 MODIFY Arg1:E46 Arg2:E39 R34 MODIFY Arg1:E47 Arg2:E39 T72 Diagnostic_procedure 1475 1527 N-terminal fragment of pro-brain natriuretic peptide E48 Diagnostic_procedure:T72 T73 Diagnostic_procedure 1529 1538 NT-proBNP E49 Diagnostic_procedure:T73 R35 IDENTICAL Arg1:E49 Arg2:E48 T74 Lab_value 1544 1555 3,996 pg/mL E50 Lab_value:T74 R36 MODIFY Arg1:E50 Arg2:E48 T75 Diagnostic_procedure 1557 1581 Nerve conduction studies E51 Diagnostic_procedure:T75 T76 Disease_disorder 1602 1626 sensory-motor neuropathy E52 Disease_disorder:T76 T77 Detailed_description 1592 1601 bilateral R37 MODIFY Arg1:T77 Arg2:E52 T78 Diagnostic_procedure 1641 1663 electromyography study E53 Diagnostic_procedure:T78 T79 Sign_symptom 1684 1695 denervation E54 Sign_symptom:T79 T80 Sign_symptom 1708 1729 reinnervation changes E55 Sign_symptom:T80 T81 Biological_structure 1737 1754 tibialis anterior T82 Biological_structure 1759 1772 gastrocnemius R38 MODIFY Arg1:T81 Arg2:E55 R39 MODIFY Arg1:T81 Arg2:E54 R40 MODIFY Arg1:T82 Arg2:E54 R41 MODIFY Arg1:T82 Arg2:E55 T83 Diagnostic_procedure 2239 2259 Coronary angiography E56 Diagnostic_procedure:T83 T84 Lab_value 2274 2280 normal E57 Lab_value:T84 R42 MODIFY Arg1:E57 Arg2:E56 T85 Diagnostic_procedure 2158 2165 Doppler E58 Diagnostic_procedure:T85 T86 Disease_disorder 2430 2441 amyloidosis E59 Disease_disorder:T86 A3 POLARITY E59 MAYBE_POS T87 Biological_structure 2422 2429 cardiac R43 MODIFY Arg1:T87 Arg2:E59 T88 Diagnostic_procedure 1774 1791 Electrocardiogram E60 Diagnostic_procedure:T88 T89 Diagnostic_procedure 1793 1796 ECG E61 Diagnostic_procedure:T89 R44 IDENTICAL Arg1:E61 Arg2:E60 T90 Lab_value 1807 1819 sinus rhythm E62 Lab_value:T90 T91 Diagnostic_procedure 1837 1847 limb leads E63 Diagnostic_procedure:T91 T92 Lab_value 1821 1833 low voltages E64 Lab_value:T92 R45 MODIFY Arg1:E64 Arg2:E63 T93 Diagnostic_procedure 1861 1890 precordial and inferior leads E65 Diagnostic_procedure:T93 R46 MODIFY Arg1:E62 Arg2:E60 R47 SUB_PROCEDURE Arg1:E63 Arg2:E60 R48 SUB_PROCEDURE Arg1:E65 Arg2:E60 T94 Lab_value 1849 1857 QS waves E66 Lab_value:T94 R49 MODIFY Arg1:E66 Arg2:E65 T95 Sign_symptom 1905 1927 atrioventricular block E67 Sign_symptom:T95 T96 Detailed_description 1892 1904 first-degree R50 MODIFY Arg1:T96 Arg2:E67 T97 Diagnostic_procedure 1943 1946 QTc E68 Diagnostic_procedure:T97 T98 Lab_value 1933 1942 prolonged E69 Lab_value:T98 R51 MODIFY Arg1:E69 Arg2:E68 T99 Diagnostic_procedure 1975 1991 echocardiography E70 Diagnostic_procedure:T99 T100 Detailed_description 1959 1974 Two-dimensional R52 MODIFY Arg1:T100 Arg2:E70 T101 Sign_symptom 2023 2032 thickened E71 Sign_symptom:T101 T102 Sign_symptom 2037 2056 speckled appearance E72 Sign_symptom:T102 T103 Detailed_description 2008 2022 concentrically R53 MODIFY Arg1:T103 Arg2:E71 T104 Biological_structure 2060 2077 ventricular walls R54 MODIFY Arg1:T104 Arg2:E72 R55 MODIFY Arg1:T104 Arg2:E71 T105 Sign_symptom 2088 2098 dilatation E73 Sign_symptom:T105 T106 Biological_structure 2079 2087 biatrial R56 MODIFY Arg1:T106 Arg2:E73 T107 Diagnostic_procedure 2104 2138 left ventricular ejection fraction E74 Diagnostic_procedure:T107 T108 Lab_value 2142 2145 70% E75 Lab_value:T108 R57 MODIFY Arg1:E75 Arg2:E74 T109 Sign_symptom 2184 2218 restrictive mitral filling pattern E76 Sign_symptom:T109 T110 Severity 2177 2183 severe R58 MODIFY Arg1:T110 Arg2:E76 T111 Diagnostic_procedure 2224 2233 E/A ratio E77 Diagnostic_procedure:T111 T112 Lab_value 2234 2237 2.1 E78 Lab_value:T112 R59 MODIFY Arg1:E78 Arg2:E77 T113 Diagnostic_procedure 2332 2335 ECG E79 Diagnostic_procedure:T113 T114 Diagnostic_procedure 2313 2324 QRS voltage E80 Diagnostic_procedure:T114 T115 Lab_value 2309 2312 low E81 Lab_value:T115 R60 MODIFY Arg1:E81 Arg2:E80 R61 SUB_PROCEDURE Arg1:E80 Arg2:E79 T116 Sign_symptom 2349 2359 thickening E82 Sign_symptom:T116 T117 Biological_structure 2337 2348 ventricular R62 MODIFY Arg1:T117 Arg2:E82 T118 Sign_symptom 2374 2395 diastolic dysfunction E83 Sign_symptom:T118 T119 Diagnostic_procedure 2463 2490 λ light-chain concentration E84 Diagnostic_procedure:T119 T120 Detailed_description 2457 2462 serum R63 MODIFY Arg1:T120 Arg2:E84 T121 Lab_value 2495 2500 1,763 E85 Lab_value:T121 R64 MODIFY Arg1:E85 Arg2:E84 T122 Diagnostic_procedure 2537 2564 κ light-chain concentration E86 Diagnostic_procedure:T122 T123 Lab_value 2569 2575 normal E87 Lab_value:T123 R65 MODIFY Arg1:E87 Arg2:E86 T124 Diagnostic_procedure 907 931 neurological examination E88 Diagnostic_procedure:T124 T125 Sign_symptom 941 949 weakness E89 Sign_symptom:T125 T126 Sign_symptom 963 970 atrophy E90 Sign_symptom:T126 T127 Biological_structure 954 962 muscular R66 MODIFY Arg1:T127 Arg2:E90 T128 Biological_structure 978 1005 bilateral tibialis anterior T129 Biological_structure 1010 1023 gastrocnemius R67 MODIFY Arg1:T128 Arg2:E90 R68 MODIFY Arg1:T129 Arg2:E90 T130 Sign_symptom 1025 1037 Hyporeflexia E91 Sign_symptom:T130 T131 Biological_structure 1051 1061 both knees T132 Biological_structure 1066 1072 ankles R69 MODIFY Arg1:T131 Arg2:E91 R70 MODIFY Arg1:T132 Arg2:E91 T133 Diagnostic_procedure 521 526 blood E92 Diagnostic_procedure:T133 #2 AnnotatorNotes E92 in the stool T134 Diagnostic_procedure 530 535 mucus E93 Diagnostic_procedure:T134 #3 AnnotatorNotes E93 in the stool T135 Lab_value 510 520 no obvious E94 Lab_value:T135 R71 MODIFY Arg1:E94 Arg2:E92 R72 MODIFY Arg1:E94 Arg2:E93 T136 Sign_symptom 561 569 tenesmus E95 Sign_symptom:T136 A4 POLARITY E95 NEG T137 Diagnostic_procedure 722 742 physical examination E96 Diagnostic_procedure:T137 T138 Diagnostic_procedure 1074 1093 Sensory examination E97 Diagnostic_procedure:T138 T139 Diagnostic_procedure 1114 1140 tactile and pain sensation E98 Diagnostic_procedure:T139 T140 Lab_value 1103 1113 diminished E99 Lab_value:T140 R73 MODIFY Arg1:E99 Arg2:E98 T141 Diagnostic_procedure 1177 1196 vibratory sensation E100 Diagnostic_procedure:T141 T142 Lab_value 1146 1172 stocking and glove pattern E101 Lab_value:T142 R74 MODIFY Arg1:E101 Arg2:E98 T143 Lab_value 1201 1217 distally reduced E102 Lab_value:T143 T144 Biological_structure 1225 1236 lower limbs R75 MODIFY Arg1:T144 Arg2:E102 R76 MODIFY Arg1:E102 Arg2:E100 R77 SUB_PROCEDURE Arg1:E98 Arg2:E97 R78 SUB_PROCEDURE Arg1:E100 Arg2:E97 T145 Diagnostic_procedure 1242 1269 motor and sensory functions E103 Diagnostic_procedure:T145 T146 Biological_structure 1273 1290 upper extremities R79 MODIFY Arg1:T146 Arg2:E103 T147 Lab_value 1296 1313 relatively spared E104 Lab_value:T147 R80 MODIFY Arg1:E104 Arg2:E103 T148 Detailed_description 2750 2765 immunomodulator R81 MODIFY Arg1:T148 Arg2:E10 R82 AFTER Arg1:E1 Arg2:E2 * OVERLAP E2 E3 E4 R1 MODIFY Arg1:T6 Arg2:E3 R83 AFTER Arg1:E4 Arg2:E18 T149 History 178 186 bloating T150 History 191 200 tasteless * OVERLAP E18 E19 E20 E21 R84 BEFORE Arg1:E21 Arg2:E22 * OVERLAP E22 E23 E24 E25 E27 E26 E28 E92 E93 E29 E95 E35 E36 R85 BEFORE Arg1:E36 Arg2:E96 * OVERLAP E96 E30 E31 E32 E33 E34 E88 E89 E90 E91 E97 E103 E39 E48 E51 E52 E53 E54 E55 E60 E67 E68 E70 E71 E72 E74 E58 E76 E77 E56 E79 E82 E83 E59 E84 E86 E37 E38 E17 R86 BEFORE Arg1:E17 Arg2:E8 * OVERLAP E8 E11 E16 E15 R87 BEFORE Arg1:E15 Arg2:E14 * OVERLAP E14 E5 E6