Gastrointestinal amyloidosis in a patient with smoldering multiple myeloma: A case report

Table 1 Laboratory parameters

Parameter	Patient value	Reference value
Hemoglobin	94 g/L	115-150 g/L
C-reactive protein	3.03 mg/L	0-5 mg/L
Erythrocyte sedimentation rate	13 mm/h	0-20 mm/h
D-dimer	2170 ng/mL	0-500 ng/mL
Serum albumin	30.23 g/L	40-55 g/L
Serum globulin	20.20 g/L	20-40 g/L
nt-proBNP	381.8 pg/mL	0-125 pg/mL
Serum calcium	2.11 mmol/L	2.11-2.52 mmol/L
Antinuclear antibodies	1:100	< 1:100
ANCA	Negative	Negative
Serum immunoglobulin kappa chain	1.77 g/L	1.7-3.7g /L
Serum immunoglobulin lambda chain	1.41 g/L	0.9-2.1 g/L
Serum free lambda/kappa	< 100	< 100
Urinary kappa (κ) chain	20.5 0 mg/L	0-7.1 mg/L
Urinary lambda (λ) chain	1110 mg/L	0-3.9 mg/L
β2 microglobulin	2216.58 ug/L	900-2700 ug/L

ANCA: Anti-neutrophil cytoplasmic antibodies.

Table 2 Summary of two case reports describing smoldering multiple myeloma and amyloidosis complicated by gastrointestinal bleeding

Ref.	Gjeorgjievski et al[5], 2015	Liyanaarachchi et al[6], 2017
Age	92	51
Gender	Female	Male
M protein type	IgG lambda M-protein	IgG lambda M-protein
Symptoms	Weakness, lethargy, orthostatic dizziness, melena	Nausea, vomiting, loss of weight, haematemesis
Endoscopy	Ulcerated mass in the stomach	Oedematous mucosa with erosions and exposed blood vessels in the stomach and duodenum
Treatment	Omeprazole	Proton pump inhibitors
Follow-up time	One month	None
Prognosis	No bleeding	Succumbed to septic shock