Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2018; 6(9): 284-290
Published online Sep 6, 2018. doi: 10.12998/wjcc.v6.i9.284
Case report and review of the literature of primary gastrointestinal amyloidosis diagnosed with enteroscopy and endoscopic ultrasonography
Yi-Pin Liu, Wei-Wei Jiang, Guo-Xun Chen, Yan-Qing Li
Yi-Pin Liu, Yan-Qing Li, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
Yi-Pin Liu, Wei-Wei Jiang, Department of Gastroenterology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, Shandong Province, China
Guo-Xun Chen, Department of Nutrition, University of Tennessee, Knoxville, TN 37996, United States
Author contributions: Liu YP performed the endoscopy examinations and wrote the manuscript; Jiang WW participated in the patient management and followed up the patient after discharge; Chen GX was involved in the writing and responsible for language editing of the manuscript; Li YQ planned and gave guidance to the research.
Informed consent statement: Written informed consent was obtained from the individual participant included in the study.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yan-Qing Li, MD, PhD, Professor, Department of Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan 250012, Shandong Province, China. liyanqing@sdu.edu.cn
Telephone: +86-531-82166090 Fax: +86-531-82166090
Received: February 27, 2018
Peer-review started: February 27, 2018
First decision: March 30, 2018
Revised: June 27, 2018
Accepted: June 28, 2018
Article in press: June 28, 2018
Published online: September 6, 2018
Processing time: 192 Days and 16.2 Hours
Abstract

Here, we report a rare case of primary gastrointestinal amyloidosis in a stable condition after being followed up for three years. The patient was admitted to the hospital in 2014. Tests showed decreased levels of hemoglobin and ferritin. Transoral and transanal enteroscopy showed multiple nodular protuberances in the esophagus, ileum, colon and rectum. Endoscopic ultrasonography indicated the nodular protuberances stemmed from the submucosa and partially invaded the intrinsic myometrium. Pathological examinations found multiple small nodules in the submucosa and dyed structures, which were positive for special Congo red dyeing. After treatment with oral iron supplements, the levels of hemoglobin and ferritin became normal. It is concluded that the patient represents a case of primary gastrointestinal amyloidosis with multiple nodular protuberances in the digestive tract with controllable moderate abdominal discomfort and anemia and a benign course. Enteroscopy and endoscopic ultrasonography play an important role in the diagnosis of primary gastrointestinal amyloidosis.

Keywords: Enteroscopy; Primary gastrointestinal amyloidosis; Endoscopic ultrasonography; Pathological diagnosis

Core tip: A 48-year-old woman was admitted with moderate abdominal discomfort for two years and decreased hemoglobin and ferritin levels. Transoral and transanal enteroscopy showed multiple nodular protuberances in the digestive tract. Endoscopic ultrasonography indicated the nodular protuberances stemmed from the submucosa and partially invaded the intrinsic myometrium. Pathological examinations showed the nodules were positive for special Congo red dyeing. It is concluded that the patient represents a case of primary gastrointestinal amyloidosis with multiple nodular protuberances in the digestive tract with controllable symptoms and a benign course during three-year follow-up. Enteroscopy and endoscopic ultrasonography play an important role in the diagnosis.