Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple Myeloma
Amyloidosis is a common complication of patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and multiple myeloma (MM). This proteinaceous material can be deposited intercellularly in any organ system, including the gastrointestinal (GI) tract....
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2015/320120 |
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| author | Mihajlo Gjeorgjievski Treta Purohit Mitual B. Amin Paul J. Kurtin Mitchell S. Cappell |
| author_facet | Mihajlo Gjeorgjievski Treta Purohit Mitual B. Amin Paul J. Kurtin Mitchell S. Cappell |
| author_sort | Mihajlo Gjeorgjievski |
| collection | DOAJ |
| description | Amyloidosis is a common complication of patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and multiple myeloma (MM). This proteinaceous material can be deposited intercellularly in any organ system, including the gastrointestinal (GI) tract. In the GI tract, amyloidosis affects the duodenum most commonly, followed by the stomach and colorectum. Gastric amyloidosis causes symptoms of nausea, vomiting, early satiety, abdominal pain, and GI bleeding. A case of upper GI bleeding from gastric amyloidosis is presented in a patient with SMM. Esophagogastroduodenoscopy (EGD) revealed a gastric mass. Endoscopic biopsies revealed amyloid deposition in the lamina propria, consistent with gastric amyloidosis. Liquid chromatography tandem mass spectrometry performed on peptides extracted from Congo red-positive microdissected areas of paraffin-embedded stomach specimens revealed a peptide profile consistent with AL- (lambda-) type amyloidosis. Based on this and multiple other case reports, we recommend that patients with GI bleeding and MGUS, SMM, or MM undergo EGD and pathologic examination of endoscopic biopsies of identified lesions using Congo red stains for amyloidosis for early diagnosis and treatment. |
| format | Article |
| id | doaj-art-203f9ded3b6841efa094aac6f6ef50d3 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-203f9ded3b6841efa094aac6f6ef50d32025-02-03T01:22:16ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362015-01-01201510.1155/2015/320120320120Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple MyelomaMihajlo Gjeorgjievski0Treta Purohit1Mitual B. Amin2Paul J. Kurtin3Mitchell S. Cappell4Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, USADivision of Gastroenterology & Hepatology, William Beaumont Hospital, Royal Oak, MI 48073, USAAnatomic Pathology, William Beaumont Hospital, Royal Oak, MI 48073, USALaboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USADivision of Gastroenterology & Hepatology, William Beaumont Hospital, Royal Oak, MI 48073, USAAmyloidosis is a common complication of patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and multiple myeloma (MM). This proteinaceous material can be deposited intercellularly in any organ system, including the gastrointestinal (GI) tract. In the GI tract, amyloidosis affects the duodenum most commonly, followed by the stomach and colorectum. Gastric amyloidosis causes symptoms of nausea, vomiting, early satiety, abdominal pain, and GI bleeding. A case of upper GI bleeding from gastric amyloidosis is presented in a patient with SMM. Esophagogastroduodenoscopy (EGD) revealed a gastric mass. Endoscopic biopsies revealed amyloid deposition in the lamina propria, consistent with gastric amyloidosis. Liquid chromatography tandem mass spectrometry performed on peptides extracted from Congo red-positive microdissected areas of paraffin-embedded stomach specimens revealed a peptide profile consistent with AL- (lambda-) type amyloidosis. Based on this and multiple other case reports, we recommend that patients with GI bleeding and MGUS, SMM, or MM undergo EGD and pathologic examination of endoscopic biopsies of identified lesions using Congo red stains for amyloidosis for early diagnosis and treatment.http://dx.doi.org/10.1155/2015/320120 |
| spellingShingle | Mihajlo Gjeorgjievski Treta Purohit Mitual B. Amin Paul J. Kurtin Mitchell S. Cappell Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple Myeloma Case Reports in Gastrointestinal Medicine |
| title | Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple Myeloma |
| title_full | Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple Myeloma |
| title_fullStr | Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple Myeloma |
| title_full_unstemmed | Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple Myeloma |
| title_short | Upper Gastrointestinal Bleeding from Gastric Amyloidosis in a Patient with Smoldering Multiple Myeloma |
| title_sort | upper gastrointestinal bleeding from gastric amyloidosis in a patient with smoldering multiple myeloma |
| url | http://dx.doi.org/10.1155/2015/320120 |
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