title: Clinical and endoscopic features of amyloidosis secondary to Crohn's disease: diagnostic value of duodenal observation and biopsy.
abstract: OBJECTIVE
  Recent reports have focused on the development of secondary amyloidosis (AMY) as a complication of Crohn's disease (CD). The present study was carried out to investigate the frequency of AMY secondary to CD, its clinical and endoscopic features, and the importance of duodenal biopsy in detecting this disease.
  
  
  METHODS
  This study involved 408 patients diagnosed with CD who were endoscopically and histologically examined at our hospital. At follow up, we analyzed the incidence of AMY complications, the clinical features of AMY and the methods to diagnose AMY.
  
  
  RESULTS
  The incidence of AMY was 2.5% (10/408). The disease type at the time of CD diagnosis was small and large bowel type (SL) in eight patients, small bowel type in one and large bowel type in one. The incidence of AMY was significantly higher in patients with SL than in patients with other disease types. The length of time from onset of CD to diagnosis of AMY was 14.1 ± 8.0 years. The cumulative incidence of AMY was 1.0% at 10 years and 5.7% at 20 years after onset. In terms of the method used to diagnose AMY, the positive rate of AMY diagnosis was 100% with endoscopic duodenal biopsy.
  
  
  CONCLUSIONS
  The incidence of AMY as a complication of CD was low (2.5%). However, because this complication adversely affects patients' prognoses, it is important to check for the presence of AMY, particularly in the duodenum, in patients for whom more than 10 years have elapsed since the development of CD.
authors.affiliation: Departments of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan. syokaki@fukuoka-u.ac.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyaoka
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
authors.forename: Takashi
authors.initials: T
authors.lastname: Hisabe
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yano
authors.forename: Fumihito
authors.initials: F
authors.lastname: Hirai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagahama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Beppu
authors.forename: Yuji
authors.initials: Y
authors.lastname: Murakami
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Maki
authors.forename: Noritaka
authors.initials: N
authors.lastname: Takatsu
authors.forename: Kazeo
authors.initials: K
authors.lastname: Ninomiya
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Ono
authors.forename: Takao
authors.initials: T
authors.lastname: Kanemitsu
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Nishimata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanabe
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ikeda
authors.forename: Seiji
authors.initials: S
authors.lastname: Haraoka
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwashita
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000686:Amyloidosis / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D002648:Child; D003424:Crohn Disease / Q000150:complications / Q000473:pathology* / Q000601:surgery; D004378:Duodenal Diseases / Q000473:pathology* / Q000601:surgery; D004384:Duodenoscopy; D004386:Duodenum / Q000473:pathology*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D000685:Serum Amyloid A Protein / Q000032:analysis; D055815:Young Adult
chemical_list: D000685:Serum Amyloid A Protein