Cargando…

Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea

We describe an autopsied case of systemic AA amyloidosis secondary to metastatic renal cell carcinoma presenting intractable diarrhea. Severe diarrhea was the major symptom for the diagnosis of AA amyloidosis. No renal symptoms which are common in AA amyloidosis secondary to renal cell carcinoma wer...

Descripción completa

Detalles Bibliográficos
Autores principales: Endo, Hiroyuki, Obara, Noriyuki, Mizuno, Shinichi, Nakamura, Yasuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624937/
https://www.ncbi.nlm.nih.gov/pubmed/37928968
http://dx.doi.org/10.1159/000531066
_version_ 1785131020017729536
author Endo, Hiroyuki
Obara, Noriyuki
Mizuno, Shinichi
Nakamura, Yasuhiro
author_facet Endo, Hiroyuki
Obara, Noriyuki
Mizuno, Shinichi
Nakamura, Yasuhiro
author_sort Endo, Hiroyuki
collection PubMed
description We describe an autopsied case of systemic AA amyloidosis secondary to metastatic renal cell carcinoma presenting intractable diarrhea. Severe diarrhea was the major symptom for the diagnosis of AA amyloidosis. No renal symptoms which are common in AA amyloidosis secondary to renal cell carcinoma were shown because hemodialysis following bilateral nephrectomy had already been started 9 years before. Treatment against metastatic tumors as a solution of AA amyloidosis could not be performed because of bad performance status and the patient died 5 months after the diagnosis. Autopsy findings revealed that AA amyloid deposition was seen in multi-organs including the intestine. The metastatic tumors were histologically compatible as metastasis of renal cell carcinoma. There was no other cause of chronic inflammation such as inflammatory arthritis. We concluded that chronic inflammation provoked by the metastatic tumors of renal cell carcinoma was a major cause of systemic AA amyloidosis. Intestinal AA amyloidosis with malabsorption was the cause of death. Clinicians should keep it in mind that solid organ malignancy can be a cause of AA amyloidosis and renal cell carcinoma is the most common carcinomatous cause. This case is particularly instructive in that progression of amyloidosis may be missed in hemodialysis patients with anuria and that gastrointestinal symptoms can be the primary indicators of systemic amyloidosis. Endoscopic examination including biopsy is important for the diagnosis and early treatment of amyloidosis.
format Online
Article
Text
id pubmed-10624937
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-106249372023-11-05 Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea Endo, Hiroyuki Obara, Noriyuki Mizuno, Shinichi Nakamura, Yasuhiro Case Rep Gastroenterol Single Case We describe an autopsied case of systemic AA amyloidosis secondary to metastatic renal cell carcinoma presenting intractable diarrhea. Severe diarrhea was the major symptom for the diagnosis of AA amyloidosis. No renal symptoms which are common in AA amyloidosis secondary to renal cell carcinoma were shown because hemodialysis following bilateral nephrectomy had already been started 9 years before. Treatment against metastatic tumors as a solution of AA amyloidosis could not be performed because of bad performance status and the patient died 5 months after the diagnosis. Autopsy findings revealed that AA amyloid deposition was seen in multi-organs including the intestine. The metastatic tumors were histologically compatible as metastasis of renal cell carcinoma. There was no other cause of chronic inflammation such as inflammatory arthritis. We concluded that chronic inflammation provoked by the metastatic tumors of renal cell carcinoma was a major cause of systemic AA amyloidosis. Intestinal AA amyloidosis with malabsorption was the cause of death. Clinicians should keep it in mind that solid organ malignancy can be a cause of AA amyloidosis and renal cell carcinoma is the most common carcinomatous cause. This case is particularly instructive in that progression of amyloidosis may be missed in hemodialysis patients with anuria and that gastrointestinal symptoms can be the primary indicators of systemic amyloidosis. Endoscopic examination including biopsy is important for the diagnosis and early treatment of amyloidosis. S. Karger AG 2023-09-13 /pmc/articles/PMC10624937/ /pubmed/37928968 http://dx.doi.org/10.1159/000531066 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Single Case
Endo, Hiroyuki
Obara, Noriyuki
Mizuno, Shinichi
Nakamura, Yasuhiro
Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea
title Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea
title_full Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea
title_fullStr Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea
title_full_unstemmed Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea
title_short Systemic AA Amyloidosis Secondary to Metastatic Renal Cell Carcinoma in a Hemodialysis Patient with Intractable Diarrhea
title_sort systemic aa amyloidosis secondary to metastatic renal cell carcinoma in a hemodialysis patient with intractable diarrhea
topic Single Case
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624937/
https://www.ncbi.nlm.nih.gov/pubmed/37928968
http://dx.doi.org/10.1159/000531066
work_keys_str_mv AT endohiroyuki systemicaaamyloidosissecondarytometastaticrenalcellcarcinomainahemodialysispatientwithintractablediarrhea
AT obaranoriyuki systemicaaamyloidosissecondarytometastaticrenalcellcarcinomainahemodialysispatientwithintractablediarrhea
AT mizunoshinichi systemicaaamyloidosissecondarytometastaticrenalcellcarcinomainahemodialysispatientwithintractablediarrhea
AT nakamurayasuhiro systemicaaamyloidosissecondarytometastaticrenalcellcarcinomainahemodialysispatientwithintractablediarrhea