Endoscopic features in amyloidosis of the small intestine: Clinical and morphologic differences between chemical types of amyloid protein

Tada, Shuji; Iida, Mitsuo; Yao, Takashi; Kawakubo, K; Yao, Tsuneyoshi; Okada, Mitsuo; Fujishima, Masatoshi

doi:10.1016/s0016-5107(94)70008-7

Cited by 109 publications

(81 citation statements)

References 16 publications

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“…These deposits are asymptomatic and should not be considered evidence of intestinal organ involvement for the purpose of counting the number of organs involved. Patients with symptomatic gastrointestinal tract involvement will have diarrhea, motility disturbances, and weight loss that strongly resemble autonomic failure [72]. Documentation of involvement via direct biopsy is feasible if it is desired to confirm intestinal involvement.…”

Section: Gastrointestinal Tractmentioning

confidence: 99%

Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): A consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis

et al. 2005

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Section: Gastrointestinal Tractmentioning

confidence: 99%

Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): A consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis

et al. 2005

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“…Autonomic neuropathy as well as amyloid infiltration of the intestinal wall cause clinical manifestations of gastrointestinal amyloidosis including dysmotility leading to pseudo-obstruction, diarrhoea and malabsorption [7]. A more frequent occurrence of diarrhoea, malabsorption and occult blood in stools is present in reactive amyloidosis [9]. In our case, severe diarrhoea developed 3 months before death.…”

Section: A S E R E P O R T : P O E M S S Y N D R O M E a N D R E A mentioning

confidence: 55%

A case of POEMS syndrome associated with reactive amyloidosis and Waldenström's macroglobulinaemia

Kihara¹,

Hori²,

Murakami³

et al. 2002

Journal of Internal Medicine

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. Kihara Y, Hori H, Murakami H, Hatakeyama Y, Yoshikawa I, Hamada T, Otsuki M (University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu, Japan). A case of POEMS syndrome associated withreactive amyloidosis and Waldenström's macroglobulinaemia (Case report). J Intern Med 2002; 252: 255–258. A72‐year‐old Japanese man presented with a 5‐year history of fatigue, night sweats, oedema of dorsum of foot, muscle weakness, and paresthesia of the lower extremities. On examination, the patient fulfilled the diagnostic criteria for POEMS syndrome, but was unusual in that he also had underling Waldenström's macroglobulinaemia with IgM κ. The M protein of POEMS syndrome is usually IgG and IgA with λ light chains. To our knowledge, there are only three cases of POEMS syndrome with IgM κ including our case. Autopsy findings revealed that small lymphocytes were more prominent than plasma cells in the bone marrow. These plasma cells were stained with IgM κ. Amyloid deposits identified by Congo red stain were detected predominantly in the vascular walls of the gastrointestinal tract, pancreas and kidney. This amyloid protein was classified as amyloid associated protein. This is the first case of POEMS syndrome associated with reactive amyloidosis and Waldenström's macroglobulinaemiae.

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“…Tada et al 8 reported that the incidence of wide granular deposits in the lamina propria mucosae was significantly higher in patients with AA amyloidosis than in patients with AL amyloidosis, and, conversely, massive amyloid deposits in the muscularis mucosae, submucosa, and muscularis propria were observed more frequently in patients with AL amyloidosis than in patients with AA amyloidosis. Massive deposits in the muscularis propria were only observed in cases of the AL type.…”

Section: Discussionmentioning

confidence: 97%

“…In the stomach, the deposition of AL amyloid as primary and solitary amyloidosis has been reported to be the most frequent, and it seems that the AL-type amyloid causes solitary amyloidosis not only in the stomach but also in the entire gastrointestinal tract. 8,14 There have been few reports on EUS features of solitary gastric amyloidosis. 2,5,9 Previously reported EUS findings included thickening of the gas- tric wall and loss of layer structure in the first 3 ultrasonographic layers.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, vascular deposits of amyloid were most apparent in the submucosa in any type of amyloid protein. 8,14 Endoscopic ultrasonographic features of AL-type amyloidosis (loss of layer structure in the first 3 endosonographic layers and wall thickening, as mentioned above) are thought to reflect histologic findings (ie, amyloid deposition and congestion and edema due to amyloid deposition in the vascular wall). 6 Conversely, EUS images of AA-type amyloidosis may mainly show echogenic and homogeneous lesions in the first and second layers, considering the histologic findings of AA-type amyloidosis.…”

Section: Discussionmentioning

confidence: 99%

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Endosonographic Features of Solitary Gastric Amyloidosis

Shibukawa

Irisawa

Takagi

et al. 2004

Journal of Ultrasound in Medicine

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lthough gastrointestinal involvement in cases of systemic amyloidosis is very common, primary and solitary amyloid tumors in the gastrointestinal tract, especially in the stomach, are rare. [1][2][3][4][5] Various changes in endoscopic findings due to the deposition of amyloid proteins in the gastrointestinal tract have been evaluated in comparison with histopathologic findings of amyloid deposition.6-8 Endoscopic ultrasonographic (EUS) images of amyloidosis have also been investigated, but EUS features of amyloidosis have been poorly characterized in a few published reports.2,4,5,9 Here we report a case of solitary amyloidosis of the stomach that was observed on EUS images, and we review the literature with regard to EUS features of amyloidosis in the gastrointestinal tract.

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Endoscopic features in amyloidosis of the small intestine: Clinical and morphologic differences between chemical types of amyloid protein

Cited by 109 publications

References 16 publications

Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): A consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis

Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): A consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis

A case of POEMS syndrome associated with reactive amyloidosis and Waldenström's macroglobulinaemia

Endosonographic Features of Solitary Gastric Amyloidosis

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