A Case Report of Two Obscurities: Amyloidosis and Occult Gastrointestinal Bleeding

Linda S. Lee, MD; Jason Hornick, MD, PhD; David L. Carr-Locke, MD, FRCP Series Editor: David L. Carr-Locke, MD, FRCP

Disclosures

September 13, 2002

In This Article

Introduction

Amyloidosis often eludes the clinician with its myriad clinical manifestations, likening it to the tuberculosis and syphilis of previous days. A systemic disorder, amyloidosis results from extracellular tissue deposition of beta-pleated sheets of fibrils of normal serum proteins. The 3 most common types of amyloidosis are: (1) primary amyloidosis, involving deposition of monoclonal light chains; (2) reactive or secondary amyloidosis, with deposits of serum amyloid A protein; and (3) dialysis-related amyloidosis (DRA), in which beta-2-microglobulin fibrils are deposited in various organs throughout the body. Gastrointestinal involvement occurs in 40% to 70% of all amyloid patients and is more common in those with reactive amyloidosis.[1,2,3] DRA appears to have a lower incidence of gastrointestinal manifestations, although the precise prevalence remains unknown.[4]

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