title: Hepatic ALECT-2 amyloidosis causing portal hypertension and recurrent variceal bleeding: a case report and review of the literature.
abstract: OBJECTIVE
  To examine laser microdissection and mass spectrometry (LMD-MS), which has emerged as a new tool to aid in typing amyloid proteins.
  
  
  RESULTS
  ALECT-2 is a potential cause of hepatic amyloidosis best detected by LMD-MS.
  
  
  METHODS
  One of the more recently reported proteins is ALECT-2 (leukocyte cell-derived chemotaxin 2) amyloid, found in renal specimens of Hispanic patients. Here we report the first case of hepatic ALECT-2 amyloidosis diagnosed by LMD-MS from a liver biopsy specimen of a 52-year-old Hispanic man and causing portal hypertension with recurrent esophageal variceal bleeding.
  
  
  CONCLUSIONS
  ALECT-2 can cause amyloidosis in organs other than the kidneys. It should be strongly considered in Hispanic patients and in those with a globular pattern of amyloid deposition. The incidence of ALECT-2 amyloidosis is likely underreported.
authors.affiliation: Royal Victoria Hospital, Division of Hematology, 687 des pins, C6.82, Montreal, Quebec, Canada H3A 1A1; jonathan.how@mcgill.ca.
authors.forename: Moussab
authors.initials: M
authors.lastname: Damlaj
authors.forename: Ramila
authors.initials: R
authors.lastname: Amre
authors.forename: Phil
authors.initials: P
authors.lastname: Wong
authors.forename: Jonathan
authors.initials: J
authors.lastname: How
mesh_terms: D000686:Amyloidosis / Q000150:complications* / Q000378:metabolism* / Q000473:pathology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004932:Esophageal and Gastric Varices / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism*; D061346:Laser Capture Microdissection; D008107:Liver Diseases / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; C103468:LECT2 protein, human
keywords: ALECT-2; Amyloidosis; Laser microdissection and mass spectrometry (LMD-MS)