Intestinal pseudo-obstruction due to dialysis amyloidosis.
Marked gastric dilatation and the carpal tunnel syndrome developed concurrently in a 58-year-old man treated with hemodialysis for 14 years. Despite extensive examinations, no attributable organic lesion was demonstrated in the gastrointestinal tract. However, amyloid deposition, which was immunohistochemically identified as beta-2 microglobulin, was demonstrated in the stomach and the synovia excised from the right carpal tunnel. Intestinal pseudo-obstruction due to dialysis amyloidosis was considered to be the cause of the gastric dilatation. There have been a few recently reported cases with dialysis amyloidosis in which extra-articular amyloid deposition resulted in overt clinical problems. The present case provides additional evidence that dialysis amyloidosis can develop serious extra-articular complications; intestinal pseudo-obstruction is a very rare gastrointestinal manifestation.
Shinoda
T
T
Department of Geriatrics, Endocrinology and Metabolism, Shinshu University School of Medicine, Matsumoto, Japan.
Komatsu
M
M
Aizawa
T
T
Shirota
T
T
Yamada
T
T
Ehara
T
T
Mizukami
E
E
D000686:Amyloidosis / Q000150:complications* / Q000209:etiology; D002349:Carpal Tunnel Syndrome / Q000209:etiology*; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013272:Stomach Diseases / Q000209:etiology*