**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Anita D'Souza, MD, MS, Associate Professor of Medicine, Medical College of Wisconsin, Milwaukee, WI

**Main Body of the Abstract**
Systemic light chain amyloidosis (AL) patients often have a lag period of increasing symptoms during which they seek healthcare. We leveraged electronic health records (EHR) data from the TriNetX research network to describe the incidence, timing, and co-occurrence of 19 red-flag diagnoses among a cohort of AL patients identified between 10/2015-12/2020. These red-flag diagnoses represented AL features and were identified using ICD codes up to 36 months pre-AL diagnosis. Among 1,401 U.S. patients with at least 36 months of pre-AL EHR data, 46% were females, 16% were non-Hispanic Black, and 6% were Hispanic. The median age was 71 (range, 21–91) years. Dyspnea and fatigue were the most prevalent, identified in 55% and 45% of patients at AL diagnosis at a median time of 8.1 (IQR 2.7, 15.9) and 7.8 (1.9, 15.8) months, respectively (Figure).  The cumulative number of red-flag diagnoses was a median (IQR) of 2 (0-4) at -24 months, 4 (2-7) at -6 months, and 5 (2-9) at AL diagnosis. Analyses of pairwise co-occurrence of diagnoses indicated high association (Cole’s coefficient, CC >0.6), with the highest inter-organ system association between autonomic neuropathy (AN) and dyspnea (CC 0.76, p0.009), neuropathy and purpura (CC 0.68, p<0.001), AN and fatigue (CC 0.68, p0.004), fatigue and purpura (CC0.65, p<0.001), and altered bowels and AN (CC0.60, p0.006). These findings provide novel information about the timing and co-occurrence of red-flag symptoms already discovered by healthcare providers as diagnoses in existing EHR of patients and could be used to develop algorithms for early identification of AL.



Timing and co-occurrence of red-flag diagnoses prior to a diagnosis of systemic light chain (AL) amyloidosis PA5 (#147)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.