Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (5): 93-97.doi: 10.6040/j.issn.1671-7554.0.2019.1443

Previous Articles    

Three cases of amyloidosis with diarrhea as the first symptom and literature review

WANG Baihui1, SONG Yanjun2, ZHANG Shuaiqing1, ZUO Xiuli3, WANG Qing1, ZHANG Aijun1, LI Ruyuan1   

  1. 1.Department of Gastroenterology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266000, Shandong, China;
    2.Department of Hematology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266000, Shandong, China;
    3.Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-09-27

PDF (PC)

42

Abstract: Objective To summarize the clinical manifestations, primary diseases and diagnosis of digestive tract amyloidosis. Methods The clinical data of 3 cases of digestive tract amyloidosis treated in department of gastroenterology,Qilu Hospital of Shandong University(Qingdao)were analyzed and relevant literature was reviewed. Results This disease had no specific clinical manifestations, which included gastrointestinal bleeding, abdominal pain, diarrhea, poor appetite and abdominal distension. Colonoscopy indicated mucosal hyperemia and irregular ulcers. Conclusion Digestive tract amyloidosis is a rare disease with complex nonspecific clinical manifestations and high misdiagnosis rate. Chronic diarrhea secondary to amyloidosis is often atypical at the initial stage. Multisystem functional impairment occurs as the disease progresses rapidly and results in poor prognosis. Therefore, amyloidosis should be differentiated from chronic diarrhea in clinical practice. Timely identification of multisystem damage and pathological biopsy are useful in the diagnosis of amyloidosis and can improve patients survival rate.

Key words: Amyloidosis, Digestive tract, Diarrhea, Systemic lupus erythematosus, Multiple myeloma

CLC Number: 

  • R442.2
[1] 葛均波, 徐永健. 内科学[M]. 8版. 北京: 人民卫生出版社, 2013: 817-817.
[2] 刘继喜, 刘芳, 史艳芬, 等. 消化道淀粉样变性患者17例临床及内镜特征分析[J]. 疑难病杂志, 2017, 16(1): 84-86. LIU Jixi, LIU Fang, SHI Yanfen, et al. Clinical and endoscopic characteristics of 17 patients with gastrointestinal amyloidosis [J]. Difficult Diseases Magazine, 2017, 16(1): 84-86.
[3] 邓家栋, 杨崇礼, 杨天楹, 等. 临床血液学[M]. 上海: 上海科技出版社, 2001: 1092.
[4] 赵卫华, 尹瑶, 姚奕斌, 等. 成人淀粉样变性85例临床分析[J]. 广西医科大学学报, 2016, 33(5): 868-870. ZHAO Weihua, YIN Yao, YAO Yibin, et al. Clinical analysis of 85 cases of adult amyloidosis [J]. Journal of Guangxi Medical University, 2016, 33(5): 868-870.
[5] Stone MJ. Amyloidosis: a final common pathway for protein deposition in tissues [J]. Blood, 1990, 75(3): 531-545.
[6] Rajkumar SV, Dispenzieri A, Kyle RA. Monoclonal gammopathy of undetermined significance, Waldenström macroglobulinemia, AL amyloidosis, and related plasma cell disorders: diagnosis and treatment [J]. Mayo Clinnic Proceedings, 2006, 81(5): 693-703.
[7] Rajkumar SV, Gertz MA, Kyle RA. Primary systemic amyloidosis with delayed progression to multiple myeloma [J]. Cancer, 1998, 82(8): 1501-1505.
[8] 夏骏, 徐菲, 杨建民, 等. 以“腹泻”为主要临床表现的Ig A型多发性骨髓[J]. 中华检验医学杂志, 2013, 36(4): 372-374. XIA Jun, XU Fei, YANG Jianmin, et al. Ig A Multiple myeloma with diarrhea as the main clinical manifestation [J]. Chinese Journal of Laboratory Medicine, 2013, 36(4): 372-374.
[9] Friedman S, Janowitz HD. Systemic amyloidosis and the gastrointestinal tract [J]. Gastroenterol Clin North Am, 1998, 27(3): 595-614.
[10] 孙维绎, 李剑. 淀粉样变性分型的研究进展[J]. 中国实验血液学杂志, 2014, 22(1): 259-262. SUN Weiyi, LI Jian. Advances in the classification of amyloidosis[J]. Journal of Experimental Hematology, 2014, 22(1): 259-262.
[11] 徐爱华. 上消化道淀粉样变性 1例[J]. 山东医药, 2002, 42(1): 7. XU Aihua. A case of upper gastrointestinal amyloidosis [J]. Shandong Medical Journal, 2002, 42(1): 7.
[12] Wechalekar AD, Gillmore JD, Hawkins PN. Systemic amyloidosis [J]. Lancet, 2016, 387(138): 2641-2654.
[13] Freudenthaler S, Hegenbart U, Schonland S, et al. Amyloid in biopsies of the gastrointestinal tract-a retrospective observational study on 542 patients [J]. Virchows Arch, 2016, 468(5): 569-577.
[14] 刘丁, 刘刚. AL型淀粉样变性病20例临床特点分析[J].首都医科大学学报, 2010, 31(3): 416-419. LIU Ding, LIU Gang. Clinical characteristics of 20 cases of AL type amyloidosis [J]. J Cap Univ Med Sci, 2010, 31(3): 416-419.
[15] 李军, 吕愈敏. 内镜及病理对胃肠道淀粉样变的诊断意义[J].中华消化内镜杂志, 2002, 19(1): 6-8. LI Jun, LYU Yumin. Diagnostic significance of endoscopy and pathology in gastrointestinal amyloidosis [J]. Chinese Journal of Digestive Endoscopy, 2002, 19(1): 6-8.
[16] John Nay, Christine O. Menias, Vincent M. Mellnick, et al. Gastrointestinal manifestations of systemic disease: a multimodality review [J]. Abdom Imaging, 2015, 40(6): 1926-1943.
[17] Narváez J, Hernández MV, Ruiz JM, et al. Rituximab therapy for AA-amyloidosis secondary to rheumatoid arthritis [J]. Joint Bone Spine, 2011, 78(1): 101-103.
[18] Chim CS, Wong WM, Nicholls J, et al. Extramedullary sites of involvement in hematologic malignancies: case 3. Hemorrhagic gastric plasmacytoma as the primary presentation in multiple myeloma [J]. Clin Oncol, 2002, 20(1): 344-347.
[19] 郑伟, 宋少柏, 祝庆孚, 等. 局限性胃淀粉样变病[J]. 中华外科杂志, 1998, 36(7): 415-416. ZHENG Wei, SONG Shaobo, ZHU Qingfu, et al. Localized amyloidosis of the stomach [J]. Chinese Journal of Surgery, 1998, 36(7): 415-416.
[20] 刘晓霞, 武金宝. 胃肠道淀粉样变性研究进展[J]. 胃肠病学, 2018, 23(2): 116-119. LIU Xiaoxia, WU Jinbao. Advances in gastrointestinal amyloidosis [J]. Gastroenterology, 2018, 23(2): 116-119.
[21] 保志军, 顾同进, 钱敏, 等. 以消化道为主的淀粉样变病一例[J]. 中华消化杂志, 2003, 23(2): 106. BAO Zhijun, GU Tongjin, QIAN Min, et al. A case of amyloidosis was mainly in digestive tract [J]. Chinese Journal of Digestion, 2003, 23(2): 106.
[22] 张红叶, 王飞. 以消化道症状为主要表现的原发性系统性淀粉样变病1例[J]. 中国皮肤性病学杂志, 2012, 26(1): 53-54. ZHANG Hongye, WANG Fei. A case of primary systemic amyloidosis with gastrointestinal symptoms [J]. The Chinese Journal of Dermatovenereology, 2012, 26(1): 53-54.
[23] 郝迎迎, 欧阳建, 周荣富, 等. 以淀粉样变为初发表现的多发性骨髓瘤 1例分析[J]. 中国误诊学杂志, 2009, 9(1): 223-224. HAO Yingying, OU Yangjian, ZHOU Furong, et al. An analysis of one case of multiple myeloma with initial presentation of amyloidosis [J]. Chinese Journal of Misdiagnostics, 2009, 9(1): 223-224.
[24] 万璐, 李玥, 麦毓麟, 等. 以腹泻为首发表现的原发性系统性淀粉样变性并多发性骨髓瘤一例[J]. 中华内科杂志, 2016, 55(2): 143-144. WAN Lu, LI Yue, MAI Yulin, et al. A case of primary systemic amyloidosis with multiple myeloma presenting first with diarrhea [J]. Chinese Journal of Internal Medicine, 2016, 55(2): 143-144.
[25] Chakraborty SK, Chowdhury A, Kar S, et al. Multiple myeloma presenting as malabsorption syndrome due to amyloidosis [J]. Assoc Physicians India, 2000, 48(9): 931-932.
[1] AN Wen, HUANG Gang, YU Yanbo, ZUO Xiuli, LI Yanqing. Diarrhea as the principal presentation of Waldenström macroglobulinemia: a case report and literature review [J]. Journal of Shandong University (Health Sciences), 2022, 60(8): 84-90.
[2] CHENG Xuan, YANG Fan, PAN Zhenglun. Systemic lupus erythematosus, antiphospholipid syndrome with cerebral venous sinus thrombosis: a case report and literature review [J]. Journal of Shandong University (Health Sciences), 2022, 60(6): 70-74.
[3] HAO Qiang, GAO Qi, ZHAO Ran, WANG Haitao, LIU Zhidong, JIANG Baofa. Effects of ambient temperature and relative humidity on rotavirus diarrhea among children under 5 years old in Shenzhen City during 2014-2016 [J]. Journal of Shandong University (Health Sciences), 2022, 60(2): 89-95.
[4] Yunfei GUO,Qiang SHU. Role of immunosuppressants in rheumatic disease-associated recurrent spontaneous abortion [J]. Journal of Shandong University (Health Sciences), 2021, 59(8): 38-43.
[5] LU Jin. Advances in the diagnosis and treatment of multiple myeloma [J]. Journal of Shandong University (Health Sciences), 2019, 57(7): 40-43.
[6] ZHUANG Maisong, WAN Yunyan, LIN Dianjie. Tracheobronchial amyloidosis: a report of 3 cases and literature review [J]. Journal of Shandong University (Health Sciences), 2018, 56(12): 39-46.
[7] XU Daxia, HOU Nan, LI Xiaofeng, WANG Chuang, KONG Meng, JIAO Guangjun, CHEN Yunzhen. Relevance between bone metabolism of glucocorticoid-induced osteoporosis and duration of glucocorticoid treatment [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 103-107.
[8] DU Jinge, CHEN Hui, YANG Xiaorong, LÜ Ming. Meta-analysis of the association between the STAT4 rs7574865 polymorphism and systemic lupus erythematosus [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 95-102.
[9] MA Zhenzhen, SUN Hongsheng, YANG Qingrui. Changes and clinical significance of serum adipokines in systemic lupus erythematosus [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 86-90.
[10] GUO Hehe, SUN Zhiqiang, LIU Yanjuan, LIU Yichen, LI Guang, ZHENG Fang. Norcantharidin influences the expression of Notch signal pathway in multiple myeloma U226 cells [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(3): 32-37.
[11] LIU Qiong, PU Yedi, DAI Guangxia, MA Jiale, YANG Jianxia, LI Lizhen, LI Hao, WANG Luqun. A microarray analysis of bortezomib-resistant gene expression in multiple myeloma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(6): 33-38.
[12] YING Yangyang, MA Dedong, XIAO Wei. Siginifcance of polarizing microscope for the diagnosis of primary tracheobronchial amyloidosis and literature review #br# [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(4): 67-69.
[13] ZHAI Shan-shan1, DING Bu-tong2, LI Hai-xia3, CHEN Yun1, CHANG Ya-li1, SANG Tan1, GUO Nong-jian1. Differential expressions of microRNAs in the CD138+ cells of multiple myeloma patients with deletion of chromosome 13 [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(5): 80-84.
[14] PU Ye-di, LI Li-zhen, MA Dao-xin, DONG Ke,ZHAO Chuan-li, SONG Qiang, WANG Lu-qun. Establishment of a bortezomib-resistant cell line KM3/BTZ of human multiple myeloma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(2): 33-.
[15] WANG Qian1, ZHANG Ying1, HOU Wei-Kai1, ZHANG Li2, XU Hua3, WANG Peng4， YU Shan1, LIU Qian1, HUANG Qing-Xian1. Correlation between type 2 diabetes associated diarrhea and changes of enteric nervous system [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(8): 13-.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd