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Clinical recognition of Al type amyloidosis of the luminal gastrointestinal tract.
- Source :
-
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2007 May; Vol. 5 (5), pp. 582-8. Date of Electronic Publication: 2007 Apr 11. - Publication Year :
- 2007
-
Abstract
- Background & Aims: Amyloidosis is characterized by the pathologic deposition of specific proteins throughout the body. Gastrointestinal involvement with amyloid associated with plasma cell dyscrasias (AL type amyloidosis) is common, but systematic description of the condition is lacking. The aim of this investigation was to characterize the clinical presentation, endoscopic findings, and histopathologic correlates in a series of patients with systemic AL amyloidosis of the luminal gastrointestinal tract.<br />Methods: Eligible patients were identified by interrogating the histopathology database of our institution during a 14-year time period. Medical record, histopathologic, and laboratory data were collected, analyzed, and correlated with endoscopic findings.<br />Results: Nineteen patients with systemic AL amyloidosis of the luminal gastrointestinal tract were identified. Gastrointestinal symptoms or signs related to amyloid involvement were noted in 95% of patients; abdominal pain, change in bowel habits, overt gastrointestinal bleeding, and complaints related to altered motility were the predominant presentations. Endoscopic abnormalities were found in nearly three fourths of patients, including ulcerations and submucosal hematomas. When gastrointestinal bleeding was the presenting symptom, submucosal hematomas were a common finding during endoscopic evaluation.<br />Conclusions: AL type amyloidosis of the luminal gastrointestinal tract is a rare disease that presents with common, nonspecific complaints. The endoscopic detection of a submucosal hematoma in the setting of gastrointestinal bleeding in patients with plasma cell dyscrasias should raise suspicion for the disease.
- Subjects :
- Aged
Aged, 80 and over
Amyloidosis complications
Databases, Factual
Endoscopy, Gastrointestinal
Female
Gastrointestinal Diseases complications
Gastrointestinal Hemorrhage etiology
Humans
Intestinal Mucosa pathology
Male
Middle Aged
Paraproteinemias complications
Retrospective Studies
Amyloidosis pathology
Gastrointestinal Diseases pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1542-7714
- Volume :
- 5
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
- Publication Type :
- Academic Journal
- Accession number :
- 17428737
- Full Text :
- https://doi.org/10.1016/j.cgh.2007.02.038