Skulstad H, Jacobsen M B, Moum B, Odegaard A
Indremedisinsk avdeling, Ostfold Sentralsykehus, Fredrikstad.
Tidsskr Nor Laegeforen. 1997 Oct 10;117(24):3489-91.
A 77 year-old man developed intermittent diarrhoea and malabsorption. Endoscopic findings and preliminary histological examination indicated ulcerative colitis. Special staining of biopsies from the duodenum and colon revealed amyloid deposits. Classification of the amyloid fibril protein verified AL-amyloidosis, and the diagnosis primary idiopathic amyloidosis was made. Amyloid deposit in the gastrointestinal tract are a common feature of primary and secondary amyloidosis. The symptoms and findings are nonspecific and resemble those of chronic inflammatory bowel disease and ischemic colitis. Secondary amyloidosis can be seen as a rare complication of Crohn's disease and ulcerative colitis. Special staining is necessary to show amyloid deposit, and the distinction between primary and secondary amyloidosis requires immunohistochemistry.
一名77岁男性出现间歇性腹泻和吸收不良。内镜检查结果及初步组织学检查提示为溃疡性结肠炎。十二指肠和结肠活检组织的特殊染色显示有淀粉样沉积物。淀粉样原纤维蛋白分类证实为AL型淀粉样变性，诊断为原发性特发性淀粉样变性。胃肠道中的淀粉样沉积物是原发性和继发性淀粉样变性的常见特征。其症状和表现无特异性，与慢性炎症性肠病和缺血性结肠炎相似。继发性淀粉样变性可视为克罗恩病和溃疡性结肠炎的罕见并发症。需要进行特殊染色以显示淀粉样沉积物，而原发性和继发性淀粉样变性的鉴别需要免疫组织化学检查。
