Yorita Kenji, Maeda Atsuki, Uchita Kunihisa, Nagai Asuto, Tanida Nobuyuki
Diagnostic Pathology, Japanese Red Cross Kochi Hospital, Kochi, JPN.
Internal Medicine, Japanese Red Cross Kochi Hospital, Kochi, JPN.
Cureus. 2024 Aug 30;16(8):e68167. doi: 10.7759/cureus.68167. eCollection 2024 Aug.
The clinical gastrointestinal manifestations of transthyretin amyloidosis (ATTR amyloidosis) are usually non-specific, and colonic bleeding or ulcers are unusual. Here, we report the case of an elderly Japanese man with ATTR amyloidosis who presented with rare gastrointestinal symptoms. An 84-year-old Japanese man was referred to our hospital because of anemia and positive fecal occult blood test results. Endoscopic examination revealed multiple small colonic erosions and/or ulcers; however, the cause remained unknown. The patient repeatedly visited our hospital for one year because of acute bloody diarrhea, anemia, and multiple persistent colonic ulcers. His symptoms improved after symptomatic treatment. The most recent gastric biopsy revealed ATTR amyloidosis, which was retrospectively detected in colon, stomach, and gallbladder specimens obtained six months, six years, and 12 years earlier, respectively. Therefore, ATTR amyloidosis should be considered in the differential diagnosis of colon-related anemia.
转甲状腺素蛋白淀粉样变性（ATTR淀粉样变性）的临床胃肠道表现通常不具有特异性，结肠出血或溃疡并不常见。在此，我们报告一例患有ATTR淀粉样变性的老年日本男性，其出现了罕见的胃肠道症状。一名84岁的日本男性因贫血和粪便潜血试验结果呈阳性而被转诊至我院。内镜检查发现多个小的结肠糜烂和/或溃疡；然而，病因仍不明。该患者因急性血性腹泻、贫血和多个持续性结肠溃疡，在一年时间里多次前来我院就诊。对症治疗后其症状有所改善。最近的胃活检显示为ATTR淀粉样变性，分别在六个月、六年和十二年前获取的结肠、胃和胆囊标本中回顾性检测到该病变。因此，在与结肠相关的贫血的鉴别诊断中应考虑ATTR淀粉样变性。
