The Digestive System Amyloidosis Clinical Meta-analysis

Objective: Summary of the digestive system amyloidosis clinical characteristics,misdiagnosis, treatment and prognosis, in order to further improve the understanding of thedisease in clinic, timely diagnosis and treatment to provide the basis.Methods: Retrieval China journal full text database (CNKI), VIP, Wanfang database,Chinese biomedical database and PubMed database from2003January to2013, and inDecember published the digestive system amyloidosis of literature, screening of63cases (upto32related report), from the age distribution of patients, the proportion of men and women,were analyzed in the digestive system involvement, classification of etiology, clinicalmanifestation, misdiagnosis, treatment and prognosis of amyloidosis.Results:(1) the disease can occur at any age, good hair at40years of age or older,accounting for89%, especially60years old of above34, accounting for54%;(2) the incidenceof male was higher than female, the ratio of2.2:1;(3) were most frequently involved in liver,followed by the stomach;(4)35cases hepatomegaly clinical manifestations, abdominaldistention in28cases,13cases of chronic diarrhea,12cases of tongue swelling, abdominalpain in10cases,8cases of hemorrhage of digestive tract, constipation in5cases,4cases ofdysphagia,2cases of jaundice. In addition to the digestive system,8cases of renalinvolvement,6cases with cardiac involvement.(5)19cases were misdiagnosed, themisdiagnosis rate was28.6%, the misdiagnosis of3cases of malignant lymphoma, gastricsignet ring cell carcinoma3cases,2cases of primary liver carcinoma,2cases of ulcerativecolitis,1cases of gastritis, gastroparesis in1cases,1cases of alcoholic liver disease,1cases ofBudd Chiari syndrome,1cases of gastroesophageal reflux disease,1cases hemangioma,1cases of gastric leather,1cases of Crohn’s disease,1cases of intestinal infection.(6) thetreatment to be immunosuppressive agents combined with hormone in the treatment of8cases,2cases of liver transplantation, autologous stem cell transplantation in2cases, gastricresection in2cases, intestinal resection in1cases.(7) primary amyloidosis variable with gastrointestinal bleeding, nutrient absorption obstacles when prognosis is poor, the averagesurvival time was8.5months.Conclusion: The digestive system amyloidosis is rare, good hair at40years of age or older,especially over the age of60, the incidence of male was higher than female, this is a raredisease，the digestive system is often involved, but no specific clinical manifestation,easilymisdiagnosed as gastric signet ring cell carcinoma and malignant lymphoma, primary livercancer, primary occurrence rate is relatively high, short survival, there is no special treatment.