Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.
Yonsei Med J. 2023 Aug;64(8):526-529. doi: 10.3349/ymj.2022.0636.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with the overproduction of serum amyloid A protein, resulting in systemic AA amyloidosis. In this report, we describe a case of gastrointestinal (GI) AA amyloidosis following SARS-CoV-2 infection. A 75-year-old male presented to the emergency department with upper abdominal pain 6 weeks post kidney transplantation. He had a history of SARS-CoV-2 infection 4 weeks prior. On day 7 of hospitalization, while receiving conservative management, the patient developed symptoms of cough and fever, leading to a diagnosis of SARS-CoV-2 reinfection. The patient's abdominal pain persisted, and hematochezia developed on day 30 of hospitalization. Esophagogastroduodenoscopy and colonoscopy revealed multiple ulcers in the stomach and colon, with histologic findings revealing the presence of amyloid A. The patient was managed conservatively and was also given remdesivir for the SARS-CoV-2 infection. His clinical symptoms subsequently improved, and endoscopic findings demonstrated improvement in multiple gastric ulcers. GI amyloidosis may be a subacute complication following SARS-CoV-2 infection in immunocompromised patients.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染与血清淀粉样蛋白 A 蛋白的过度产生有关，导致全身性 AA 淀粉样变性。在本报告中，我们描述了一例 SARS-CoV-2 感染后发生的胃肠道（GI）AA 淀粉样变性。一名 75 岁男性在肾移植后 6 周因上腹痛就诊于急诊科。他在 4 周前有 SARS-CoV-2 感染史。住院第 7 天，在接受保守治疗时，患者出现咳嗽和发热症状，导致 SARS-CoV-2 再感染的诊断。患者的腹痛持续存在，住院第 30 天出现血便。食管胃十二指肠镜和结肠镜检查显示胃和结肠有多发性溃疡，组织学检查显示存在淀粉样 A。患者接受了保守治疗，并因 SARS-CoV-2 感染接受了瑞德西韦治疗。他的临床症状随后得到改善，内镜检查显示多个胃溃疡有所改善。GI 淀粉样变性可能是免疫功能低下患者 SARS-CoV-2 感染后的亚急性并发症。
