Amyloidosis of the colon

Kumar, Sanath; Appavu, Samuel K.; Abcarian, Herand; Barreta, Telly

doi:10.1007/bf02563751

Cited by 21 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, it has been postulated that disruption of the connective tissue network in the muscularis propria results in impairment of the coordinated movements of the longitudinal and circular muscle layers [26,27]. Indeed, megacolon has been observed in patients with certain systemic connective tissue disorders, including Ehlers-Danlos Syndrome [EDS [28-31]], amyloidosis [32] and scleroderma [33,34]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Colonic Motor Disturbances in Chronic Megacolon in Adults

et al. 2015

View full text Add to dashboard Cite

Background Chronic megacolon is a rare disease of the colonic motor function characterized by a permanent increase in colonic diameter. Methods We reviewed electronic medical records of all patients diagnosed with chronic megacolon from 1999 to 2014 at Mayo Clinic. Our aim was to summarize clinical and motility features, including colonic compliance and tone measured by colonic barostat-controlled 10cm long infinitely compliant balloon. Colonic compliance curves were compared to healthy (40) and disease (47) control groups. Results Among 24 identified patients, the mean maximal colonic diameter on abdominal radiograph was 12.7±0.8cm. The cause of megacolon was idiopathic in 16/24, and secondary in 8/24. A relatively high prevalence (10/24) of comorbid pelvic floor dyssynergia was identified. At the time of this report, 16 patients had undergone colectomy. In general, megacolon presented high fasting colonic volume at relatively low pressures (16-20mmHg), suggesting high colonic compliance; similarly, volumes at operating pressures that ensured apposition of the balloon to the colonic wall suggested low colonic tone. Median balloon volume at 44mmHg distension was 584mL (IQR 556.5-600) in patients with megacolon compared to 251mL (212-281) in healthy, 240mL (207-286) in functional constipation and 241mL (210.8-277.5) in diarrhea-predominant irritable bowel syndrome controls. Colon's tonic response to feeding was generally intact, and there was frequently maintained phasic contractile response to feeding. Conclusions Chronic megacolon is a severe colonic dysmotility, manifesting radiologically with increased colonic diameter; it can be proven by measuring colonic compliance, and typically requires colectomy because of failed medical therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Features and Colonic Motor Disturbances in Chronic Megacolon in Adults

et al. 2015

View full text Add to dashboard Cite

show abstract

“…10 Rare cases of amyloidosis being a risk factor for volvulus have been reported in the literature. 11 Tissue sampling of the right colon in our patient was negative for Congo red stain and polarization, excluding amyloidosis as the culprit of her volvulus. In most hospitalized patients, the etiology of volvulus is multifactorial.…”

Section: Discussionmentioning

confidence: 66%

Cecal volvulus associated with carfilzomib use for al amyloidosis

Tuler

Kaur

Dasanu

2022

J Oncol Pharm Pract

View full text Add to dashboard Cite

Introduction Proteasome inhibitors have emerged as quintessential therapies for light-chain (AL) amyloidosis and multiple myeloma in the last decade. While these agents are highly effective, reports have also documented toxicities affecting various organ systems. Whereas gastrointestinal (GI) toxicities are a relatively common occurrence with proteasome inhibitors, severe GI complications are exceedingly rare. Case Report We describe a unique case of a patient with AL amyloidosis who developed cecal volvulus after four weeks of treatment with carfilzomib. This severe GI manifestation has not been previously described in the literature. Management and Outcome The patient required right hemicolectomy. After clinical recovery, she restarted reduced-dose carfilzomib. She did not have any severe GI side effects following dose reduction, and continues with the current treatment regimen to the present day. Discussion/Conclusion The causality between volvulus and the treatment with carfilzomib was probable, with a documented score of 6 on the Naranjo probability nomogram. The exact mechanism behind this effect of carfilzomib has yet to be elucidated.

show abstract

“…The clinical manifestations of amyloid deposit into the colon may mimic other diseases including inflammatory bowel disease, malignancy, ischemic colitis, and collagenous colitis [44][45][46][47]. Complications include colonic dilatation, pseudo-obstruction, stricture formation, rectal bleeding, submucosal hemorrhage, volvulus, infarction, and perforation [41,[48][49][50][51][52].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Clinical management of gastrointestinal amyloidosis

Isomoto¹,

Kamo²,

Chen³

et al. 2012

OJGas

View full text Add to dashboard Cite

Amyloidosis is characterized by extracellular deposition of abnormal protein, consisting of primary, secondary, hemodialysis-related, hereditary, senile and localized type. Primary amyloidosis is associated with monoclonal light chains. Secondary amyloidosis is associated with inflammatory, infectious, and neoplastic diseases. Amyloid deposition in the gastrointestinal tract can manifest the symptoms including diarrhea, steatorrhea, or constipation. For diagnosis, one should obtain an immunofixation of serum or urine as well as biopsy sampling of gastrointestinal mucosa stained specifically. While most gastrointestinal complications are managed symptomatically, treatment depends upon the type of amyloidosis. Causal therapy is reserved for a select few from various subtypes of this disorder

show abstract

Amyloidosis of the colon

Cited by 21 publications

References 11 publications

Clinical Features and Colonic Motor Disturbances in Chronic Megacolon in Adults

Clinical Features and Colonic Motor Disturbances in Chronic Megacolon in Adults

Cecal volvulus associated with carfilzomib use for al amyloidosis

Clinical management of gastrointestinal amyloidosis

Contact Info

Product

Resources

About