Primary amyloidosis involving the gastrointestinal tract, mesentery and omentum: A case report

Duan,Guihua; Qi,Min; Guo,Qiang; Song,Zhengji

doi:10.3892/etm.2021.10579

Primary amyloidosis involving the gastrointestinal tract, mesentery and omentum: A case report

Authors:
- Guihua Duan
- Min Qi
- Qiang Guo
- Zhengji Song
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Affiliations: Department of Gastroenterology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan 650032, P.R. China, Department of Radiology, The Third People's Hospital of Kunming City, The Sixth Affiliated Hospital of Dali University, Kunming, Yunnan 650041, P.R. China
Published online on: August 9, 2021 https://doi.org/10.3892/etm.2021.10579
Article Number: 1145
Copyright: © Duan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Amyloidosis, a systemic disease characterized by the deposition of misfolded protein, is difficult to rapidly diagnose due to its wide range of symptoms. The present study reported on a case of primary amyloidosis (AL) with involvement of the gastrointestinal tract, mesentery and omentum in a 66‑year‑old male presenting with recurrent diarrhoea and abdominal distension. Oesophagogastroduodenoscopy and enteroscopy revealed multiple gastric ulcers and multiple protuberant lesions in the colon. Laparotomy indicated multiple nodules in the mesentery of the small intestine. Contrast‑enhanced CT revealed dilation of the small bowel with pneumatosis intestinalis and positive Congo red staining of gastric mucosa and mesentery biopsy specimens confirmed amyloid deposition. Therefore, the patient was diagnosed with AL. In this case, the clinical manifestation of mesentery amyloidosis was multiple nodules and extensive peritoneal adhesions, which, to the best of our knowledge, has not been reported by any previous study.

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1	Hazenberg BP, van Gameren II, Bijzet J, Jager PL and van Rijswijk MH: Diagnostic and therapeutic approach of systemic amyloidosis. Neth J Med. 62:121–128. 2004.PubMed/NCBI
2	Asakura K, Yanai S, Nakamura S, Kawaski K, Eizuka M, Ishida K, Sugai T, Ueda M, Yamashita T, Ando Y and Matsumoto T: Endoscopic findings of small-bowel lesions in familial amyloid polyneuropathy: A case report. Medicine (Baltimore). 95(e2896)2016.PubMed/NCBI View Article : Google Scholar
3	Wang Z, Huang C and Ji F: Primary amyloidosis mimicking Crohn's disease: A case report. Int J Clin Exp Med. 8:16137–16139. 2015.PubMed/NCBI
4	Siau K, Elzubeir A, Cooper SC and Iqbal T: Amyloidosis: An unusual cause of upper gastrointestinal bleeding. BMJ Case Rep. 2016(bcr2016217653)2016.PubMed/NCBI View Article : Google Scholar
5	Groisman GM and Cohen HI: Small intestinal amyloidosis: A rare cause of diverticular disease. Case Rep Pathol. 2014(362835)2014.PubMed/NCBI View Article : Google Scholar
6	Vanhoenacker F, Vanwambeke K and Jacomen G: Amyloidosis: An unusual cause of mesenteric, omental and lymph node calcifications. JBR-BTR. 97:283–286. 2014.PubMed/NCBI View Article : Google Scholar
7	Coulier B, Montfort L, Doyen V and Gielen I: MDCT findings in primary amyloidosis of the greater omentum and mesentery: A case report. Abdom Imaging. 35:88–91. 2010.PubMed/NCBI View Article : Google Scholar
8	Horger M, Vogel M, Brodoefel H, Schimmel H and Claussen C: Omental and peritoneal involvement in systemic amyloidosis: CT with pathologic correlation. AJR Am J Roentgenol. 186:1193–1195. 2006.PubMed/NCBI View Article : Google Scholar
9	Halm U, Berr F, Tannapfel A, Klöppel R, Secknus R and Mössner J: Primary amyloidosis of the mesentery and the retroperitoneum presenting with lymphedema. Am J Gastroenterol. 93:2299–2300. 1998.PubMed/NCBI View Article : Google Scholar
10	Poturoğlu S, Mungan Z, Boztaş G, Kaymakoglu S, Ozdil S, Akyüz F, Aksoy N, Kamali S, Pinarbasi B, Cevikbaş U and Okten A: Peritoneal amyloidosis caused by familial mediterranean fever. J Gastroenterol Hepatol. 20:325–326. 2005.PubMed/NCBI View Article : Google Scholar
11	Sipe JD and Cohen AS: Review: History of the amyloid fibril. J Struct Biol. 130:88–98. 2000.PubMed/NCBI View Article : Google Scholar
12	Sipe JD, Benson MD, Buxbaum JN, Ikeda S, Merlini G, Saraiva MJ and Westermark P: Nomenclature 2014: Amyloid fibril proteins and clinical classification of the amyloidosis. Amyloid. 21:221–224. 2014.PubMed/NCBI View Article : Google Scholar
13	Freudenthaler S, Hegenbart U, Schönland S, Behrens HM, Krüger S and Röcken C: Amyloid in biopsies of the gastrointestinal tract-a retrospective observational study on 542 patients. Virchows Arch. 468:569–577. 2016.PubMed/NCBI View Article : Google Scholar
14	Cowan AJ, Skinner M, Seldin DC, Berk JL, Lichtenstein DR, O'Hara CJ, Doros G and Sanchorawala V: Amyloidosis of the gastrointestinal tract: A 13-year, single-center, referral experience. Haematologica. 98:141–146. 2013.PubMed/NCBI View Article : Google Scholar
15	Patel RR and Planche K: Applied peritoneal anatomy. Clin Radiol. 68:509–520. 2013.PubMed/NCBI View Article : Google Scholar
16	Coffey JC and O'Leary DP: The mesentery: Structure, function, and role in disease. Lancet Gastroenterol Hepatol. 1:238–247. 2016.PubMed/NCBI View Article : Google Scholar
17	Raghunathan V, Louis D and Wirk B: Gastrointestinal tract amyloidosis presenting with pneumatosis intestinalis. J Clin Med Res. 9:654–658. 2017.PubMed/NCBI View Article : Google Scholar
18	Khalil PN, Huber-Wagner S, Ladurner R, Kleespies A, Siebeck M, Mutschler W, Hallfeldt K and Kanz KG: Natural history, clinical pattern, and surgical considerations of pneumatosis intestinalis. Eur J Med Res. 14:231–239. 2009.PubMed/NCBI View Article : Google Scholar
19	Khalid F, Kaiyasah H, Binfadil W, Majid M, Hazim W and ElTayeb Y: Pneumatosis intestinalis due to gastrointestinal amyloidosis: A case report & review of literature. Int J Surg Case Rep. 23:29–32. 2016.PubMed/NCBI View Article : Google Scholar
20	Gertz MA: How to manage primary amyloidosis. Leukemia. 26:191–198. 2012.PubMed/NCBI View Article : Google Scholar