A Diagnostic Challenge in a Patient with Intractable Nausea and Vomiting: A Case of Systemic Amyloidosis

Ali Ghani; Naveed Ali

A Diagnostic Challenge in a Patient with Intractable Nausea and Vomiting: A Case of Systemic Amyloidosis

Ali Ghani * §

Contact

Naveed Ali

Contact

Thomas Jefferson University Hospital, Icahn School o...

A Diagnostic Challenge in a Patient with Intractable Nausea and Vomiting: A Case of Systemic Amyloidosis

Article Fingerprint

ReserarchID

MRJK8SZ

A Diagnostic Challenge in a Patient with Intractable Nausea and Vomiting: A Case of Systemic Amyloidosis Banner

Key Research Insights

Synthesized scholarly intelligence & interactive research assistant

This converted HTML version may contain rendering inconsistencies. Please refer to the PDF for the authoritative version, or click here to provide feedback.

Abstract

Amyloidosis is a rare disorder caused by deposition of amyloid fibrils in various tissues causing structural and functional defects. Depending upon organs involved, it may be categorized as localized or systemic. Systemic amyloidosis involves multiple organs where some organs are affected more commonly than others. Diagnosis is often challenging as in a 76-yearsold female described here who presented with intractable nausea and vomiting. Clinical course was complicated because of simultaneous presence of peptic ulcer disease and hypothyroidism. Involvement of multiple systems including gastrointestinal tract, thyroid, liver, heart and kidneys was seen, and diagnosis was achieved after renal biopsy showing Congo red staining and apple green birefringence. Gastric and thyroid infiltration by amyloidosis are extremely rare occurrences described very infrequently in the literature. However, to our knowledge, involvement of both organs in a single patient has not been reported in the literature.

References

26 Cites in Article

Reference Format

1. R Falk,R Comenzo,M Skinner (1997). The Systemic Amyloidoses. N Engl J Med, 337, 898-909.
2. G Merlini,V Bellotti (2003). Molecular Mechanisms of Amyloidosis. N Engl J Med, 349, 583-596.
3. Raymond Comenzo (2009). How I treat amyloidosis. Blood, 114(15), 3147-3157.
4. Nelson Leung,Samih Nasr,Sanjeev Sethi (2012). How I treat amyloidosis: the importance of accurate diagnosis and amyloid typing. Blood, 120(16), 3206-3213.
5. Prayman Sattianayagam,Philip Hawkins,Julian Gillmore (2009). Amyloid and the GI tract. Expert Review of Gastroenterology & Hepatology, 3(6), 615-630.
6. S Petre,I Shah,N Gilani (2008). Review article: gastrointestinal amyloidosis: clinical features, diagnosis and therapy. Alimentary Pharmacology and Therapeutics, 27(11), 1006-1016.
7. A Cowan,M Skinner,D Seldin,J Berk,D Lichtenstein,C O'hara,G Doros,V Sanchorawala (2013). Amyloidosis of the gastrointestinal tract: a 13-year, single-center, referral experience. Haematologica, 98(1), 141-146.
8. S Said,K Grogg,T Smyrk (2015). Gastric amyloidosis: clinicopathological correlations in 79 cases from a single institution. Hum Pathol, 46(4), 491-498.
9. David Menke,Robert Kyle,C Fleming,James Wolfe,Paul Kurtin,Warner Oldenburg (1993). Symptomatic Gastric Amyloidosis in Patients With Primary Systemic Amyloidosis. Mayo Clinic Proceedings, 68(8), 763-767.
10. R Leong,K Nio,L Plumley,E Molmenti,Jds Klein (2014). Systemic amyloidosis causing intestinal hemorrhage and pseudo-obstruction. Journal of Surgical Case Reports, 87.
11. Rachel Koppelman,Neil Stollman,Francisco Baigorri,Arvey Rogers (2000). Acute small bowel pseudo-obstruction due to AL amyloidosis: a case report and literature review. The American Journal of Gastroenterology, 95(1), 294-296.
12. Konstantinos Liapis,Fotios Michelis,Sosanna Delimpasi,Themistoklis Karmiris (2011). Intestinal pseudo-obstruction associated with amyloidosis. Amyloid, 18(2), 76-78.
13. K Katsanos,N Tzambouras,D Christodoulou,E Tsianos,K Bourantas (2000). Acute small bowel pseudo-obstruction due to AL-amyloidosis. Am J Gastroenterol, 95(11), 3329-3331.
14. M Rich (1995). Hypothyroidism in association with systemic amyloidosis. Head Neck, 17(4), 343-345.
15. M Siddiqui,M Gertz,D Dean (2007). Amyloid goiter as a manifestation of primary systemic amyloidosis. Thyroid, 17(1), 77-80.
16. G Hamed,C Heffess,B Shmookler,B Wenig (1995). Amyloid goiter. A clinicopathologic study of 14 cases and review of the literature. Am J Clin Pathol, 104(3), 306-312.
17. Miguel Park,Paul Mueller,Robert Kyle,Dirk Larson,Matthew Plevak,Morie Gertz (2003). Primary (AL) Hepatic Amyloidosis. Medicine, 82(5), 291-298.
18. Yong Shin (2011). Hepatic amyloidosis. The Korean Journal of Hepatology, 17(1), 80.
19. R Son,J Chang,J Choi (2011). Primary hepatic amyloidosis: report of an unusual case presenting as a mass. Korean J Radiol, 12(3), 382-385.
20. Y Wang,C Zhao,H Yin (2012). Primary hepatic amyloidosis: a mini literature review and five cases report. Ann Hepatol, 11(5), 721-727.
21. S Dubrey,K Cha,J Anderson (1998). The clinical features of immunoglobulin light-chain (AL) amyloidosis with heart involvement. QJM, 91(2), 141-157.
22. Simon Dubrey,Karen Cha,Robert Simms,Martha Skinner,Rodney Falk (1996). Electrocardiography and Doppler echocardiography in secondary (AA) amyloidosis. The American Journal of Cardiology, 77(4), 313-315.
23. M Gertz,R Comenzo,R Falk (2005). Definition of organ involvement and treatment response in immunoglobulin light-chain amyloidosis (AL): a consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis. Am J Hematol, 79, 319-328.
24. M Khalighi,W Wallace,Palma-Diaz Mf (2014). Amyloid nephropathy. Clinical Kidney Journal, 7(2), 97-106.
25. H Von Hutten,M Mihatsch,H Lobeck,B Rudolph,M Eriksson,C Röcken (2009). Prevalence and origin of amyloid in kidney biopsies. Am J Surg Pathol, 33(8), 1198-1205.
26. E Desport,F Bridoux,C Sirac (2012). Unknown Title. Orphanet Journal of Rare Diseases, 7, 54.

Download References

Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

Ethical Approval

No ethics committee approval was required for this article type.

Data Availability

Not applicable for this article.

How to Cite This Article

Ali Ghani, Naveed Ali. 2016. "A Diagnostic Challenge in a Patient with Intractable Nausea and Vomiting: A Case of Systemic Amyloidosis". Global Journal of Medical Research - C: Microbiology & Pathology GJMR-C Volume 15 (GJMR Volume 15 Issue C5).

More Citation Formats

Select Citation Style:

Download Citation

GJMR Volume 15 Issue C5

Explore Journals Explore Volume Read This Issue

Journal Specifications

Crossref Journal DOI 10.17406/gjmr

Print ISSN 0975-5888

e-ISSN 2249-4618

Keywords

Not Found

Classification

GJMR-C Classification NLMC Code: WI 146

Submission ReceivedDecember 6, 2014
Peer Review Double Blind
Handling Editor
Accepted January 1, 2015
Published January 15, 2015

Version of record

v1.2

Issue date

January 6, 2016

Language

English

Order Article Reprint

Experiance in AR

Explore published articles in an immersive Augmented Reality environment. Our platform converts research papers into interactive 3D books, allowing readers to view and interact with content using AR and VR compatible devices.

View in VR

Read in 3D

Your published article is automatically converted into a realistic 3D book. Flip through pages and read research papers in a more engaging and interactive format.

View in 3D

Article Matrices

Total Score: 175

Country: United States

Subject: Global Journal of Medical Research

Authors: Naveed Ali, Ali Ghani, Apurva Gandhi, Ritesh Rampure, Herbert E. Auerbach DO (PhD/Dr. count: 0)

View Count (all-time): 335

Total Views (Real + Logic): 997

Total Downloads (simulated): 75

Publish Date: 2015 01, Thu

Monthly Totals (Real + Logic):

Month 1: 31 views
Month 2: 40 views
Month 3: 50 views
Month 4: 37 views
Month 5: 19 views
Month 6: 53 views
Month 7: 49 views
Month 8: 24 views
Month 9: 35 views
Month 10: 51 views
Month 11: 31 views
Month 12: 29 views
Month 13: 26 views
Month 14: 25 views
Month 15: 41 views
Month 16: 34 views
Month 17: 26 views
Month 18: 31 views
Month 19: 19 views
Month 20: 36 views
Month 21: 43 views
Month 22: 24 views
Month 23: 33 views
Month 24: 42 views
Month 25: 27 views
Month 26: 39 views
Month 27: 32 views
Month 28: 21 views
Month 29: 25 views
Month 30: 26 views
Month 31: 29 views
Month 32: 26 views
Month 33: 12 views
Month 34: 29 views
Month 35: 31 views
Month 36: 24 views
Month 37: 27 views
Month 38: 33 views
Month 39: 35 views
Month 40: 40 views
Month 41: 12 views
Month 42: 40 views
Month 43: 33 views
Month 44: 21 views
Month 45: 21 views
Month 46: 29 views
Month 47: 39 views
Month 48: 18 views
Month 49: 39 views
Month 50: 35 views
Month 51: 18 views
Month 52: 45 views
Month 53: 38 views
Month 54: 31 views
Month 55: 35 views
Month 56: 25 views
Month 57: 37 views
Month 58: 47 views
Month 59: 37 views
Month 60: 27 views
Month 61: 35 views
Month 62: 24 views
Month 63: 30 views
Month 64: 14 views
Month 65: 31 views
Month 66: 36 views
Month 67: 22 views
Month 68: 34 views
Month 69: 19 views
Month 70: 28 views
Month 71: 40 views
Month 72: 45 views
Month 73: 34 views
Month 74: 35 views
Month 75: 40 views
Month 76: 17 views
Month 77: 43 views
Month 78: 38 views
Month 79: 25 views
Month 80: 36 views
Month 81: 39 views
Month 82: 14 views
Month 83: 12 views
Month 84: 30 views
Month 85: 30 views
Month 86: 25 views
Month 87: 19 views
Month 88: 35 views
Month 89: 22 views
Month 90: 32 views
Month 91: 19 views
Month 92: 20 views
Month 93: 46 views
Month 94: 27 views
Month 95: 32 views
Month 96: 19 views
Month 97: 28 views
Month 98: 43 views
Month 99: 32 views
Month 100: 43 views
Month 101: 23 views
Month 102: 22 views
Month 103: 44 views
Month 104: 33 views
Month 105: 47 views
Month 106: 31 views
Month 107: 14 views
Month 108: 48 views
Month 109: 24 views
Month 110: 28 views
Month 111: 40 views
Month 112: 24 views
Month 113: 32 views
Month 114: 45 views
Month 115: 34 views
Month 116: 22 views
Month 117: 15 views
Month 118: 37 views
Month 119: 37 views
Month 120: 33 views
Month 121: 21 views
Month 122: 60 views
Month 123: 47 views
Month 124: 43 views
Month 125: 45 views
Month 126: 21 views
Month 127: 43 views
Month 128: 28 views
Month 129: 38 views
Month 130: 18 views
Month 131: 25 views
Month 132: 27 views
Month 133: 33 views
Month 134: 35 views
Month 135: 31 views
Month 136: 36 views
Month 137: 30 views
Month 138: 46 views
Month 139: 53 views
Month 140: 57 views
Month 141: 32 views

Total Views: 997

Total Downloads: 75

All Trends