Clinical features are varied and depend entirely on biochemical nature of the fibril protein. Frequent sites of involvement:

• Kidney: seen with AA and AL; proteinuria, nephrosis, azotemia.
• Liver: occurs in AA, AL, and AF; hepatomegaly.
• Skin: characteristic of AL but can be seen in AA; raised waxy papules.
• Heart: common in AL and AF; CHF, cardiomegaly, arrhythmias.
• GI: common in all types; GI obstruction or ulceration, hemorrhage, protein loss, diarrhea, macroglossia, disordered esophageal motility.
• Joints: usually AL, frequently with myeloma; periarticular amyloid deposits, "shoulder pad sign": firm amyloid deposits in soft tissue around the shoulder, symmetric arthritis of shoulders, wrists, knees, hands.
• Nervous system: prominent in AF; peripheral neuropathy, postural hypotension, dementia. Carpal tunnel syndrome may occur in AL and Aβ₂M.
• Respiratory: lower airways can be affected in AL; localized amyloid can cause obstruction along upper airways.