Secondary Amyloidosis Presenting as Ischemic Proctitis
A 49-year-old man presented with abdominal pain and rectal bleeding for two days associated with a 50-pound unintentional weight loss. History was notable for hypertension, chronic kidney disease, obesity, gout, and acute cholecystitis status post cholecystectomy. Computed tomography (CT) of the abd...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2021/6663391 |
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| author | Saad Hashmi Assad Munis Ryan T. Hoff Hymie Kavin Eli D. Ehrenpreis |
| author_facet | Saad Hashmi Assad Munis Ryan T. Hoff Hymie Kavin Eli D. Ehrenpreis |
| author_sort | Saad Hashmi |
| collection | DOAJ |
| description | A 49-year-old man presented with abdominal pain and rectal bleeding for two days associated with a 50-pound unintentional weight loss. History was notable for hypertension, chronic kidney disease, obesity, gout, and acute cholecystitis status post cholecystectomy. Computed tomography (CT) of the abdomen and pelvis showed rectal wall thickening. Colonoscopy showed proctitis with superficial ulcerations. In the setting of renal insufficiency, malabsorption, and low-voltage QRS complexes on electrocardiogram (ECG), amyloidosis was considered in the differential diagnosis. Rectal and renal biopsies with subsequent retrospective staining of gallbladder tissue confirmed amyloid deposition. Gastrointestinal involvement of amyloidosis is relatively uncommon. Particularly, amyloid deposition in the gallbladder and rectum is very rare. The development of AA amyloidosis in our patient may have been related to gout, obesity, and the presence of a heterozygous complex variant for the MEFV (familial Mediterranean fever) gene. Awareness of this atypical presentation of amyloidosis is important, as additional staining of biopsy samples is necessary, and diagnosis allows for directed treatment. |
| format | Article |
| id | doaj-art-34013366bb634a4dbdd6cb778caa0432 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-34013366bb634a4dbdd6cb778caa04322025-02-03T05:49:18ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362021-01-01202110.1155/2021/66633916663391Secondary Amyloidosis Presenting as Ischemic ProctitisSaad Hashmi0Assad Munis1Ryan T. Hoff2Hymie Kavin3Eli D. Ehrenpreis4Advocate Lutheran General Hospital, Department of Internal Medicine, Park Ridge, IL, USAAdvocate Lutheran General Hospital, Department of Internal Medicine, Division of Gastroenterology, Park Ridge, IL, USAAdvocate Lutheran General Hospital, Department of Internal Medicine, Division of Gastroenterology, Park Ridge, IL, USAAdvocate Lutheran General Hospital, Department of Internal Medicine, Division of Gastroenterology, Park Ridge, IL, USAAdvocate Lutheran General Hospital, Department of Internal Medicine, Division of Gastroenterology, Park Ridge, IL, USAA 49-year-old man presented with abdominal pain and rectal bleeding for two days associated with a 50-pound unintentional weight loss. History was notable for hypertension, chronic kidney disease, obesity, gout, and acute cholecystitis status post cholecystectomy. Computed tomography (CT) of the abdomen and pelvis showed rectal wall thickening. Colonoscopy showed proctitis with superficial ulcerations. In the setting of renal insufficiency, malabsorption, and low-voltage QRS complexes on electrocardiogram (ECG), amyloidosis was considered in the differential diagnosis. Rectal and renal biopsies with subsequent retrospective staining of gallbladder tissue confirmed amyloid deposition. Gastrointestinal involvement of amyloidosis is relatively uncommon. Particularly, amyloid deposition in the gallbladder and rectum is very rare. The development of AA amyloidosis in our patient may have been related to gout, obesity, and the presence of a heterozygous complex variant for the MEFV (familial Mediterranean fever) gene. Awareness of this atypical presentation of amyloidosis is important, as additional staining of biopsy samples is necessary, and diagnosis allows for directed treatment.http://dx.doi.org/10.1155/2021/6663391 |
| spellingShingle | Saad Hashmi Assad Munis Ryan T. Hoff Hymie Kavin Eli D. Ehrenpreis Secondary Amyloidosis Presenting as Ischemic Proctitis Case Reports in Gastrointestinal Medicine |
| title | Secondary Amyloidosis Presenting as Ischemic Proctitis |
| title_full | Secondary Amyloidosis Presenting as Ischemic Proctitis |
| title_fullStr | Secondary Amyloidosis Presenting as Ischemic Proctitis |
| title_full_unstemmed | Secondary Amyloidosis Presenting as Ischemic Proctitis |
| title_short | Secondary Amyloidosis Presenting as Ischemic Proctitis |
| title_sort | secondary amyloidosis presenting as ischemic proctitis |
| url | http://dx.doi.org/10.1155/2021/6663391 |
| work_keys_str_mv | AT saadhashmi secondaryamyloidosispresentingasischemicproctitis AT assadmunis secondaryamyloidosispresentingasischemicproctitis AT ryanthoff secondaryamyloidosispresentingasischemicproctitis AT hymiekavin secondaryamyloidosispresentingasischemicproctitis AT elidehrenpreis secondaryamyloidosispresentingasischemicproctitis |