Published online Apr 16, 2014. doi: 10.4253/wjge.v6.i4.144
Revised: March 6, 2014
Accepted: March 11, 2014
Published online: April 16, 2014
Core tip: This case report of a 58-year-old African-American woman with coffee-ground emesis highlights a rare instance where AL (kappa)-type amyloidosis presents as gastrointestinal hemorrhage in the absence of clinical disease elsewhere in the body. Esophagogastroduodenoscopy initially revealed punctate, erythematous lesions throughout the stomach as well as regions of small bowel mucosa that appeared scalloped, ulcerated, and hemorrhaged on contact. Patient was treated for cytomegalovirus gastritis based on biopsy results. However, repeat enteroscopy continued to demonstrate friable and irregular duodenal mucosa with pathology highlighting infiltration and expansion of the lamina propria and submucosa. Appropriate staining and subtyping established AL (kappa)-type amyloidosis.