Suchartlikitwong Sakolwan, Tantrachoti Pakpoom, Mingbunjerdsuk Thammasak, Laoveeravat Passisd, Rakvit Ariwan
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Department of Gastroenterology, Texas Tech University Health Sciences Center, Lubbock, Texas.
ACG Case Rep J. 2018 Jun 6;5:e44. doi: 10.14309/crj.2018.44. eCollection 2018.
Light-chain amyloidosis is caused by deposition of immunoglobulin light chains within multiple organs, including the gastrointestinal (GI) tract. Gastrointestinal hemorrhage is a less frequent presentation. Endoscopic findings are nonspecific, and bleeding mucosal polyps are rare. We report a 59-year-old Hispanic woman with a history of gastric polyps who presented with recurrent GI hemorrhage from mucosal polyps. She had periorbital purpura and macroglossia. Biopsy of the gastric polyp confirmed amyloid deposition. Bonemarrow biopsy revealed plasma cell myeloma. She was treated with endoscopic intervention and arterial embolization to control the bleeding, and with chemotherapy for multiple myeloma.
轻链淀粉样变性是由免疫球蛋白轻链在包括胃肠道在内的多个器官中沉积所致。胃肠道出血是较少见的表现。内镜检查结果无特异性,出血性黏膜息肉罕见。我们报告一名59岁有胃息肉病史的西班牙裔女性,她因黏膜息肉反复出现胃肠道出血。她有眶周紫癜和巨舌。胃息肉活检证实有淀粉样沉积。骨髓活检显示为浆细胞骨髓瘤。她接受了内镜干预和动脉栓塞以控制出血,并接受了多发性骨髓瘤化疗。