Case Report
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World J Gastrointest Endosc. Apr 16, 2014; 6(4): 144-147
Published online Apr 16, 2014. doi: 10.4253/wjge.v6.i4.144
Rare presentation of primary (AL) amyloidosis as gastrointestinal hemorrhage without systemic involvement
Mohammad F Ali, Anik Patel, Stephanie Muller, David Friedel
Mohammad F Ali, Department of Internal Medicine, Winthrop University Hospital, Mineola, NY 11501, United States
Anik Patel, David Friedel, Department of Gastroenterology, Hepatology and Nutrition, Winthrop University Hospital, Mineola, NY 11501, United States.
Stephanie Muller, Department of Pathology, Winthrop University Hospital, Mineola, NY 11501, United States
Author contributions: Ali MF and Friedel D designed the report; Friedel D and Patel A performed the endoscopic procedure and provided the endoscopic image; Ali MF collected the patient’s clinical data; Muller S provided the pathology images and related interpretation and analyses; Ali MF researched/reviewed the current literature and wrote the paper.
Correspondence to: Mohammad F Ali, MD, Resident Physician, Department of Internal Medicine, Winthrop University Hospital, 222 Station Plaza North, Suite 509, Mineola, NY 11501, United States.
Telephone: +1-516-6632381 Fax: +1-516-6638796
Received: December 30, 2013
Revised: March 6, 2014
Accepted: March 11, 2014
Published online: April 16, 2014
Core Tip

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.