title: Primary Amyloidosis Manifesting as Cholestatic Jaundice after Laparoscopic Cholecystectomy.
abstract: A 71-year-old female patient with cholelithiasis who had undergone laparoscopic cholecystectomy was admitted with obstructive jaundice (total bilirubin ~6 mg/dL) three months later. An ERCP was performed, in which a gallstone was found, followed by a sphincterotomy and cleansing of the bile duct. Due to deterioration of jaundice (>25 mg/dL), a new, unsuccessful ERCP and stent placement was carried out. Because of ongoing cardiac failure, she underwent an echocardiogram which revealed restrictive cardiomyopathy possibly due to amyloidosis. A liver biopsy was performed, which was positive for amyloid deposits in the liver, and the diagnosis was confirmed by the detection of monoclonal λ IgG protein in urine. The patient's jaundice gradually deteriorated and she died one week later from hepatic insufficiency.
authors.affiliation: 3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Chaidari, 12462 Athens, Greece.
authors.forename: Evangelos P
authors.initials: EP
authors.lastname: Misiakos
authors.affiliation: 3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Chaidari, 12462 Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Bagias
authors.affiliation: Department of Histology and Embryology, University of Athens School of Medicine, Goudi, 11527 Athens, Greece.
authors.forename: Dina
authors.initials: D
authors.lastname: Tiniakos
authors.affiliation: 3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Chaidari, 12462 Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Roditis
authors.affiliation: 3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Chaidari, 12462 Athens, Greece.
authors.forename: Nick
authors.initials: N
authors.lastname: Zavras
authors.affiliation: 2nd Department of Internal Medicine, Endoscopy Unit, University of Athens School of Medicine, Attikon University Hospital, Chaidari, 12462 Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papanikolaou
authors.affiliation: 2nd Department of Internal Medicine, Hematology Unit, University of Athens School of Medicine, Attikon University Hospital, Chaidari, 12462 Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsirigotis
authors.affiliation: 1st Department of Surgery, University of Athens School of Medicine, Laikon Hospital, Goudi, 11527 Athens, Greece.
authors.forename: Theodore
authors.initials: T
authors.lastname: Liakakos
authors.affiliation: 3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Chaidari, 12462 Athens, Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Machairas