Amyloidosis of the Endometrium: An Asymptomatic Presentation

Winkler, Danielle D.; Emery, Jacqueline A.; Alan, Carol B.

doi:10.1097/01.aog.0000124985.48138.7e

Cited by 6 publications

(5 citation statements)

References 4 publications

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“…Cases involving the reproductive tract are rare. Only 12 cases of cervical amyloid, 3–7 four cases of uterine amyloid and one case of systemic amyloidosis with endometrial involvement are reported in the literature 8 …”

Section: Introductionmentioning

confidence: 54%

Primary localised amyloidosis of the vagina

Pehlivanov¹,

Belovegdov²,

Ivanov³

et al. 2008

Aust NZ J Obst Gynaeco

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Section: Introductionmentioning

confidence: 54%

Primary localised amyloidosis of the vagina

Pehlivanov¹,

Belovegdov²,

Ivanov³

et al. 2008

Aust NZ J Obst Gynaeco

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“…In our literature search on uterine amyloidoses associated with systemic amyloidosis, as a rare site of involvement compared to other organs, we have identified five cases only. Four of them were AL amyloidosis and just one was AA amyloidosis [9][10][11][12][13]. Two of the AL amyloidosis patients had multiple myeloma and two had primary amyloidosis.…”

Section: Discussionmentioning

confidence: 99%

“…AA amyloidosis was found in 8.6% of 2246 patients with FMF in a study conducted in Turkey [4]. Gynecological amyloidosis has also been documented, albeit rarely [5][6][7][8][9][10][11][12][13]. The majority of reported cases were localized amyloidoses [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Menorrhagia due to uterine amyloidosis in familial Mediterranean fever: case-based review

2020

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Amyloidosis is described by the deposition of misfolded proteins in the tissues. Amyloidoses are classified into two as systemic and localized. Out of the systemic forms, AL (light chain) amyloidosis is the most prevalent type; however, amyloid A (AA) amyloidosis is more frequently encountered in the rheumatology practice. AA amyloidosis stands out as a major complication of familial Mediterranean fever (FMF). Splenic and renal involvement is more likely in FMF-associated systemic amyloidosis. The involvement of thyroid and adrenal glands has also been described, although infrequently. Amyloidoses have a heterogeneous plethora of clinical manifestations, with certain phenotypes associated with specific amyloid forms. Gynecological amyloidosis is a rare condition. Uterine involvement may occur in a localized fashion or may also arise as a part of systemic involvement, albeit at a lesser ratio. Several cases of uterine AL amyloidosis have been documented so far as an organ involvement in systemic AL amyloidosis. On the other hand, uterine amyloidosis associated with AA amyloidosis has been described merely in one case with rheumatoid arthritis (RA). Here, we presented a 40-year-old female patient with FMF known for 38 years who underwent splenectomy and hysterectomy due to massive splenomegaly, deep anemia, and persistent menometrorrhagia. Histological examinations of materials revealed uterine and splenic AA amyloidosis. This case report is first-of-its-kind to describe FMF-associated uterine AA amyloidosis and also provides a discussion of possible mechanisms of amyloidosis-induced uterine bleeding.

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“…A higher incidence of bleeding following liver biopsy in hepatic amyl-oidosis has been documented in the past [1]. Large controlled trials have yet to evaluate the connection between liver biopsy and amyloidosis though a small case series in the 1960s did mention the potential risk for bleeding [22]. In fact, recent research has emphasized the increased risk of bleeding from liver biopsy in patients with amyloid deposition though the transjugular approach has decreased such risks when compared to the percutaneous method [23,24].…”

Section: Discussionmentioning

confidence: 99%

Amyloidosis presenting as acute liver failure: a case report

Parikh¹,

Tsai²

2014

Intern Med Inside

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Introduction: Amyloidosis has two principle types: multiple myeloma-associated (AL) and amyloidassociated amyloidosis (AA). Both types can be local or systemic and can often involve the liver. Hepatic amyloidosis carries a poor prognosis, but commonly presents with a more gradual time course of evolving hepatomegaly and elevated serum alkaline phosphatase. This casereport involves an unusual presentation of hepatic amyloidosis with acute liver decompensation resulting in death. Case presentation: A 76 year old man presented with complaints of progressive weakness and anorexia resulting in weight loss. He was initially found to have laboratory abnormalities notable for cholestasis and a mild transaminitis. On exam, the patient was cachectic with scleral icterus, jaundice, and abdominal distention. Liver ultrasound with doppler imaging was significant for increased echogenicity of the liver and ascites. The patient underwent transjugular liver biopsy, which demonstrated hepatic amyloid. Additional testing revealed a diagnosis of amyloidosis secondary to multiple myeloma. On day 5 of the patient's admission, cholestasis and transaminitis acutely worsened, with eventual peaking of aspartate aminotransferase to 3362 u/l, alanine aminotransferase to 1439 u/l, and total bilirubin to 18.8 mg/d. Further work-up for this acute decompensation, including imaging and laboratory tests, did not reveal any triggering events such as portal vein thrombosis or intra-abdominal bleeding from recent liver biopsy. Additionally, cardiovascular compromise, infectious etiologies, and toxins were ruled out. Unfortunately, the patient was not a candidate for chemotherapy given his acute hepatic decompensation and subsequent encephalopathy on day 8 of admission. The patient was started on Lactulose and N-acetylcysteine, though his mental status continued to worsen and the patient died on day 10 of admission from multi-organ compromise secondary to acute liver failure. Conclusion: Amyloidosis resulting in acute hepatic failure has previously been reported but remains quite rare. Clinicians must consider infiltrative diseases, such as multiple myeloma and amyloidosis, when patients present with an extended prodromal illness paired with unexplained, worsening hepatic dysfunction. Likewise, physicians should be aware that patients who present with hepatic amyloid secondary to multiple myeloma are at high risk for rapid clinical deterioration.

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Amyloidosis of the Endometrium: An Asymptomatic Presentation

Cited by 6 publications

References 4 publications

Primary localised amyloidosis of the vagina

Primary localised amyloidosis of the vagina

Menorrhagia due to uterine amyloidosis in familial Mediterranean fever: case-based review

Amyloidosis presenting as acute liver failure: a case report

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