Ali MF, Patel A, Muller S, Friedel D. Rare presentation of primary (AL) amyloidosis as gastrointestinal hemorrhage without systemic involvement. World J Gastrointest Endosc 2014; 6(4): 144-147 [PMID: 24748922 DOI: 10.4253/wjge.v6.i4.144]
Corresponding Author of This Article
Mohammad F Ali, MD, Resident Physician, Department of Internal Medicine, Winthrop University Hospital, 222 Station Plaza North, Suite 509, Mineola, NY 11501, United States. mfali@winthrop.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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World J Gastrointest Endosc. Apr 16, 2014; 6(4): 144-147 Published online Apr 16, 2014. doi: 10.4253/wjge.v6.i4.144
Rare presentation of primary (AL) amyloidosis as gastrointestinal hemorrhage without systemic involvement
Mohammad F Ali, Anik Patel, Stephanie Muller, David Friedel
Mohammad F Ali, Department of Internal Medicine, Winthrop University Hospital, Mineola, NY 11501, United States
Anik Patel, David Friedel, Department of Gastroenterology, Hepatology and Nutrition, Winthrop University Hospital, Mineola, NY 11501, United States.
Stephanie Muller, Department of Pathology, Winthrop University Hospital, Mineola, NY 11501, United States
Author contributions: Ali MF and Friedel D designed the report; Friedel D and Patel A performed the endoscopic procedure and provided the endoscopic image; Ali MF collected the patient’s clinical data; Muller S provided the pathology images and related interpretation and analyses; Ali MF researched/reviewed the current literature and wrote the paper.
Correspondence to: Mohammad F Ali, MD, Resident Physician, Department of Internal Medicine, Winthrop University Hospital, 222 Station Plaza North, Suite 509, Mineola, NY 11501, United States. mfali@winthrop.org
Telephone: +1-516-6632381 Fax: +1-516-6638796
Received: December 30, 2013 Revised: March 6, 2014 Accepted: March 11, 2014 Published online: April 16, 2014
Core Tip
Core tip: This case report of a 58-year-old African-American woman with coffee-ground emesis highlights a rare instance where AL (kappa)-type amyloidosis presents as gastrointestinal hemorrhage in the absence of clinical disease elsewhere in the body. Esophagogastroduodenoscopy initially revealed punctate, erythematous lesions throughout the stomach as well as regions of small bowel mucosa that appeared scalloped, ulcerated, and hemorrhaged on contact. Patient was treated for cytomegalovirus gastritis based on biopsy results. However, repeat enteroscopy continued to demonstrate friable and irregular duodenal mucosa with pathology highlighting infiltration and expansion of the lamina propria and submucosa. Appropriate staining and subtyping established AL (kappa)-type amyloidosis.
