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十二指肠淀粉样变性致乙型肝炎相关性肝硬化吸收不良:1例罕见病例报告

Duodenal Amyloidosis Inducing Malabsorption in Hepatitis B-Related Liver Cirrhosis: A Rare Case Presentation.

作者信息

Ghosh Chanchal Kumar, Sarker Aditi, Islam Sumona, Islam Nafizul, Chowdhury Prodipta, Islam Mahjabin, Bari Amit

机构信息

Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, BGD.

Department of Gastroenterology, Bangladesh Medical College Hospital, Dhaka, BGD.

出版信息

Cureus. 2025 Mar 6;17(3):e80147. doi: 10.7759/cureus.80147. eCollection 2025 Mar.

Abstract

Chronic hepatitis B virus (HBV) infection is a major cause of liver cirrhosis worldwide. While hepatic complications are well-documented, extra-hepatic manifestations such as secondary amyloidosis are less common and can lead to diverse and complex clinical outcomes. Here, we present the case of a 60-year-old male with a history of chronic hepatitis B who progressed to liver cirrhosis and presented with chronic, unexplained, intractable diarrhea unresponsive to standard treatments. He also experienced significant unintentional weight loss and generalized weakness. Further investigations revealed amyloid deposition in the duodenum, confirming secondary amyloidosis affecting the gastrointestinal tract as the cause of malabsorption. Persistent diarrhea and malabsorption necessitated nutritional support and symptomatic management. This case highlights the rare association between chronic liver disease (CLD), secondary amyloidosis, and malabsorption syndrome, emphasizing the importance of clinical suspicion for timely diagnosis. Early recognition and prompt intervention are crucial to managing these complex cases, improving outcomes, and preventing further complications.

摘要

慢性乙型肝炎病毒(HBV)感染是全球肝硬化的主要原因。虽然肝脏并发症已有充分记录,但诸如继发性淀粉样变性等肝外表现较为少见,可导致多样且复杂的临床结果。在此,我们报告一例60岁男性病例,该患者有慢性乙型肝炎病史,已进展为肝硬化,并出现慢性、不明原因、难治性腹泻,对标准治疗无反应。他还出现了明显的非故意体重减轻和全身无力。进一步检查发现十二指肠有淀粉样沉积,证实继发性淀粉样变性累及胃肠道是吸收不良的原因。持续性腹泻和吸收不良需要营养支持和对症治疗。该病例突出了慢性肝病(CLD)、继发性淀粉样变性和吸收不良综合征之间的罕见关联,强调了临床怀疑对于及时诊断的重要性。早期识别和及时干预对于处理这些复杂病例、改善预后以及预防进一步并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b50/11972009/7f7384f8d987/cureus-0017-00000080147-i01.jpg

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