Primary gastrointestinal amyloidosis with gastrointestinal hemorrhage and intestinal pseudo-obstruction: a report of a rare case

Clin J Gastroenterol. 2019 Jun;12(3):258-262. doi: 10.1007/s12328-018-00929-9. Epub 2018 Dec 20.

Abstract

Amyloidosis is a syndrome involving amyloid protein deposition in various organs, resulting in organ dysfunction. Symptoms of gastrointestinal amyloidosis are usually nonspecific, such as diarrhea and body weight loss. We, here, report a patient who presented to the hospital with simultaneous hematemesis, melena, and intestinal pseudo-obstruction, leading to a diagnosis of primary gastrointestinal amyloidosis based on computed tomography (CT) and endoscopic findings. CT showed diffuse wall thickening from the duodenum to the jejunum, jejunal dilation, and fluid accumulation throughout the gastrointestinal tract. Upper gastrointestinal endoscopy revealed duodenal mucosal edema, jejunal dilation, and small hemorrhages from jejunal mucosal erosion. The definite diagnosis was done based on biopsy results. This report describes the early diagnosis of gastrointestinal amyloidosis based on CT and endoscopy findings.

Keywords: Amyloidosis; Gastrointestinal amyloidosis; Hemorrhage; Pseudo-obstruction.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Amyloidosis / complications*
  • Amyloidosis / diagnostic imaging*
  • Duodenal Diseases / complications*
  • Endoscopy, Gastrointestinal
  • Female
  • Hematemesis / etiology*
  • Humans
  • Intestinal Pseudo-Obstruction / etiology*
  • Jejunal Diseases / complications*
  • Melena / etiology*
  • Tomography, X-Ray Computed