Clinical Analysis Of Gastrointestinal Amyloidosis

Background and ObjectiveAmyloidosis is a heterogeneous disease which is caused by the deposition of amyloid in the interstitial space,thus causing organ dysfunction.The patients'performances involving digestive system are not specific,often due to the primary disease,the site and amount of deposition of amyloid.Therefore,misdiagnosis and missed diagnosis are prone to happen.The study was devised to retrospectively analyze the clinical features as well as diagnosis and treatment methods of gastrointestinal amyloidosis,in order to improve the diagnostic accuracy of the disease and reduce misdiagnosis rate.MethodsA total of 6 patients with gastrointestinal amyloidosis diagnosed by endoscopic biopsy during January 2013 to September 2017 in Sir Run Run Shaw Hospital,Zhejiang University,School of Medicine were collected.The clinical features,auxiliary examinations,endoscopic features,diagnosis,treatment and prognosis of these patients were summarized and analyzed.ResultsThe main clinical manifestations of gastrointestinal amyloidosis include abdominal pain and distention,diarrhea,nausea and vomiting,gastrointestinal bleeding,which were uncharacteristic.Laboratory and imaging studies also lack specificity;including hypoproteinemia,anemia,and abnormalities of immunoglobulin,blood free light chain,protein electrophoresis and immune immobilization electrophysiological.Abdominal CT prompted different degrees of gastrointestinal dilatation,edema,celia effusion and so on.Endoscopes mainly showed as mucosal edema,congestion and erosion,bleeding,ulcers,etc.Definite diagnosis was confirmed by histopathology with positive Congo red staining.Common treatment options include chemotherapy and symptomatic and supportive care.The disease has poor prognosis with no specific treatment.ConclusionsGastrointestinal amyloidosis is rare disease lacking of specificity of clinical manifestations and laboratory examinations.However,when patients have gastrointestinal symptoms combined with hypoproteinemia,anemia,and other multi-system performance,we must take this disease into consideration.Diagnosis mainly depends on pathology via endoscopic biopsy.The disease has no specific and effective treatment.