Recurrent gastric hemorrhaging with large submucosal hematomas in a patient with primary AL systemic amyloidosis: endoscopic and histopathological findings.
A 64-year-old woman who suffered intractable gastric ulcers with hemorrhaging showed huge submucosal hematomas in her stomach on the endoscopic examination. Since gastric mucosal biopsy revealed amyloid deposition and IgG lambda type M protein was detectable in her serum, she was diagnosed as having primary AL systemic amyloidosis. The gastric hemorrhages did not improve despite intensive medication, so total gastrectomy was performed, resulting in an unfavorable outcome. Massive deposition of amyloid with A lambda immunoreactivity was seen on the submucosal vessels in her stomach. This is a rare primary AL systemic amyloidosis case showing recurrent and fatal gastric submucosal hematomas.
Department of Medicine, Suwa Red Cross Hospital, Suwa.
Naoko
N
Iijima-Dohi
Akihiro
A
Shinji
Toshiki
T
Shimizu
Sho-Zou
SZ
Ishikawa
Kenji
K
Mukawa
Tomotugu
T
Nakamura
Keiko
K
Maruyama
Yoshinobu
Y
Hoshii
Shu-Ichi
S
Ikeda
D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D005773:Gastroscopy; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D013272:Stomach Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D013276:Stomach Ulcer / Q000175:diagnosis / Q000209:etiology / Q000601:surgery