title: Primary hepatic amyloidosis: A case report and review of literature.
abstract: We describe a case of 42-year-old female presenting with abdominal pain associated with loss of weight and fever for 8 mo. On evaluation she had gross hepatomegaly with raised alkaline phosphatase and raised GGT levels with normal transaminases and bilirubin. On imaging she had diffuse enlargement of liver with heterogeneous contrast uptake in liver. Her viral marker and autoimmune markers were negative. Liver biopsy depicted massive deposition of amyloid in peri-sinusoidal spaces which revealed apple green birefringence on polarizing microscopy after Congo red staining. Cardiac and renal evaluation was unremarkable. Abdominal fat pad and rectum biopsy was negative for amyloid deposit. There was no evidence of primary amyloidosis as bone marrow examination was normal. Serum and urine immunofixation electrophoresis were normal. Immunoperoxidase staining for serum amyloid associated protein for secondary amyloidosis was negative from liver biopsy. We present this rare case of primary hepatic amyloidosis and review the literature regarding varied presentations of hepatic involvement in amyloidosis.
authors.affiliation: Nikhil Sonthalia, Samit Jain, Sunil Pawar, Vinay Zanwar, Ravindra Surude, Praveen M Rathi, Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Mumbai 400008, Maharashtra, India.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Sonthalia
authors.affiliation: Nikhil Sonthalia, Samit Jain, Sunil Pawar, Vinay Zanwar, Ravindra Surude, Praveen M Rathi, Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Mumbai 400008, Maharashtra, India.
authors.forename: Samit
authors.initials: S
authors.lastname: Jain
authors.affiliation: Nikhil Sonthalia, Samit Jain, Sunil Pawar, Vinay Zanwar, Ravindra Surude, Praveen M Rathi, Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Mumbai 400008, Maharashtra, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Pawar
authors.affiliation: Nikhil Sonthalia, Samit Jain, Sunil Pawar, Vinay Zanwar, Ravindra Surude, Praveen M Rathi, Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Mumbai 400008, Maharashtra, India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Zanwar
authors.affiliation: Nikhil Sonthalia, Samit Jain, Sunil Pawar, Vinay Zanwar, Ravindra Surude, Praveen M Rathi, Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Mumbai 400008, Maharashtra, India.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Surude
authors.affiliation: Nikhil Sonthalia, Samit Jain, Sunil Pawar, Vinay Zanwar, Ravindra Surude, Praveen M Rathi, Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Mumbai 400008, Maharashtra, India.
authors.forename: Praveen M
authors.initials: PM
authors.lastname: Rathi
keywords: Amyloid associated protein; Amyloidosis; Congo red staining; Immunofixation electrophoresis; Isolated hepatic amyloidosis