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Primary Amyloidosis with Variform Lesions in the Gastrointestinal Tract, Report of a Case Masayoshi Kajimura 1 , Fumitoshi Watanabe 1 , Eizo Kaneko 1 , Katsutoshi Miura 2 , Osamu Kino 3 1The First Department of Internal Medicine, Hamamatsu University School of Medicine 2The Second Department of Pathology, Hamamatsu University School of Medicine 3The First Department of Pathology, Hamamatsu University School of Medicine pp.145-149
Published Date 1988/2/25
DOI https://doi.org/10.11477/mf.1403107879
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 A 58 year-old man was admitted to our hospital because of hematochezia, pretibial edema, and exertional dyspnea. Chest x-ray examination revealed cardiomegaly, pleural effusion, and micronodular shadow in both lower lung fields (Fig. 1). Proteinuria was also found. Barium enema examination revealed narrowing and irregular mucosal ulcerations in the rectosigmoid junction simulating ischemic colitis (Fig. 2 a). Colonoscopic examination showed various lesions ; longitudinal and irregular ulcers, and purpuric hemorrhagic and blackish raised mucosal areas which were thought to represent hematoma (Fig. 3 a - e). X-ray and endoscopic examinations of the duodenal bulb showed small nodules and mucosal purpuric hemorrhage (Fig. 2 b, 4 a, b). Biopsies of the rectum, duodenal cap, and stomach showed amyloid deposition (Fig. 5 a, b). The patient was diagnosed as having primary amyloidosis (AL), because there was no underlying disease and histochemically detected amyloid was resistant to potassium permanganate and did not react with anti-AA and antiprealbumine antibodies. The treatment by predonine and DMSO (dimethyl sulfoxide) was not effective. Six months later he died suddenly due to heart failure. Autopsy confirmed primary amyloidosis with generalized involvement.


Copyright © 1988, Igaku-Shoin Ltd. All rights reserved.

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

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