Vol 10, No 2 (2019)
Review paper
Published online: 2019-06-15

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Gastrointestinal amyloidosis

Renata Talar-Wojnarowska1
DOI: 10.5603/Hem.a2019.0018
Hematologia 2019;10(2):87-94.

Abstract

Gastrointestinal (GI) amyloidosis represents a significant diagnostic challenge due to its nonspecific clinical features. The amyloid depositions can interfere with GI tract organ structure and function, most notably with the liver and small bowel. Clinical symptoms of GI amyloidosis include weight loss, chronic diarrhoea, abdominal pain, and GI bleeding. Pathological examination establishes the diagnosis with a demonstration of Congo red positive substance with apple green birefringence. Although a rare manifestation of amyloidosis, staining for amyloid should be considered in all patients undergoing GI biopsy who have unexplained chronic symptoms. Hepatomegaly and elevation of alkaline phosphatase are the most common clinical and biochemical findings in liver involvement. Prognosis varies depending on the aetiology of the disease, with hepatic involvement and malnutrition leading to the poorest outcomes.

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