An Incidental Finding of AL‑associated Amyloidosis Presenting as Gastric Ulcers

ABSTRACT

Gastrointestinal tract amyloidosis has been reported in rare instances and related symptoms are usually nonspecific to the disease process. We present a patient who initially had melena on anticoagulation and endoscopy revealed a bleeding gastric ulcer. Hemostasis was achieved. The patient had a recurrence of symptoms despite being off anticoagulation months later and at that time repeat endoscopy showed multiple gastric ulcers with surrounding friable mucosa. Biopsy results were significant for light chain associated‑amyloidosis. This case represents a rare cause of gastric ulcer.

Keywords

Gastric amyloid - gastrointestinal bleed - light‑chain amyloid

• REFERENCES

• 1 James DG, Zuckerman GR, Sayuk GS, Wang HL, Prakash C. Clinical recognition of al type amyloidosis of the luminal gastrointestinal tract. Clin Gastroenterol Hepatol 2007; 5: 582-8
• 2 Sawada T, Adachi Y, Akino K, Arimura Y, Ishida T, Ishii Y. et al. Endoscopic features of primary amyloidosis of the stomach. Endoscopy 2012; 44 Suppl 2 UCTN E275-6
• 3 Menke DM, Kyle RA, Fleming CR, Wolfe 3rd JT, Kurtin PJ, Oldenburg WA. et al. Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis. Mayo Clin Proc 1993; 68: 763-7
• 4 Cowan AJ, Skinner M, Seldin DC, Berk JL, Lichtenstein DR, O'Hara CJ. et al. Amyloidosis of the gastrointestinal tract: A 13-year, single-center, referral experience. Haematologica 2013; 98: 141-6
• 5 Das K, Ghoshal UC, Jain M, Rastogi A, Tiwari S, Pandey R. et al. Primary gastric lymphoma and Helicobacter pylori infection with gastric amyloidosis. Indian J Gastroenterol 2005; 24: 220-2
• 6 Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV. et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014; 15: e538-48