[Case of acute necrotizing esophagitis associated with AA amyloidosis secondary to bronchiectasis].
An 82-year-old woman with a history of bronchiectasis for 20 years was admitted to our hospital with anorexia and diarrhea. Sigmoidoscopy showed multiple mucosal erythematous areas and erosions. Histologic examination with Congo red stain revealed massive amyloid deposition around the submucosal vessels as well as in the parenchyma of the mucosa and submucosa. With immunohistochemistry, the diagnosis of secondary/reactive AA amyloidosis was confirmed. Esophagogastroduodenoscopy demonstrated diffuse dark brown mucosa, establishing the diagnosis of acute necrotizing esophagitis. Ischemia associated with amyloid deposition of the vessels in the esophagus was considered to be a possible etiology of acute necrotizing esophagitis. Additionally, gastric outlet obstruction and gastroesophageal reflux associated with gastroduodenal erosions caused by amyloid deposition were supposed to be another factor. Amyloid deposition in the esophageal mucosa may cause a reduction in mucosal defense that is responsible for the pathogenesis. We report the first case of acute necrotizing esophagitis associated with amyloidosis.
Department of Gastroenterology, Fukui Prefectural Hospital.
Kenkei
K
Hasatani
Noriko
N
Shibata
Yoshihide
Y
Naitou
Yukimitsu
Y
Torii
Satoshi
S
Nishiyama
Kazuto
K
Takahashi
Haruo
H
Fujinaga
Yoshiaki
Y
Hayashi
Hiroyuki
H
Aoyagi
Sei
S
Tatsumi
Naoyuki
N
Ibe
Kouji
K
Urasaki
Yasuharu
Y
Kaizaki
D000208:Acute Disease; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D001987:Bronchiectasis / Q000150:complications*; D004941:Esophagitis / Q000209:etiology* / Q000473:pathology; D004947:Esophagus / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D009092:Mucous Membrane / Q000378:metabolism; D009336:Necrosis / Q000209:etiology; D000685:Serum Amyloid A Protein / Q000378:metabolism*
D000685:Serum Amyloid A Protein