Dialysis-related Amyloidosis Masaaki Kobayashi 1,2 1Department of Internal Medicine, Shinrakuen Hospital Keyword: 透析アミロイドーシス , 消化管アミロイドーシス , β2-ミクログロブリン , 虚血性大腸病変 pp.619-627
Published Date 2003/4/24
DOI https://doi.org/10.11477/mf.1403100922
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 Dialysis-related amyloidosis affects predominantly the osteoarticular system, but subsequently, gastrointestinal involvement also occurs. We studied 52 patients with dialysis-related amyloidosis to evaluate the prevalence and the clinicopathological characteristics of gastrointestinal amyloidosis. Of 42 autopsy cases, 34(81 %)had amyloid deposits in the gastrointestinal tract. The degree of amyloid deposition tended to increase significantly with time on dialysis. We found no difference in the prevalence of amyloid deposition in the stomach, small intestine, and large intestine. Thirty-two(76%)cases showed mild to severe amyloid deposition in the submucosal vessel walls. Because only 5(12%)cases revealed subtle amyloid deposition in the muscularis mucosa, we were unable to identify gastrointestinal amyloidosis endoscopically. In 5 cases with gastrointestinal complication of the paralytic ileus or malnutrition, massive amyloid deposition in the proper muscle, especially the teniae coli was observed extensively. Three patients underwent emergency colectomy due to necrotic ischemic colitis with moderate vascular amyloid deposition.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院