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Gastric amyloidosis in a patient with dysphagia

Dysphagia is a symptom with a broad differential diagnosis. Usually, the etiology of dysphagia is benign, but it is essential to rule out serious causes. It is also critical to think outside the box when the etiology is not obvious. Herein, we describe a case of multiple myeloma that initially prese...

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Autores principales: Ghazaleh, Sami, Hindupur, Anay, Nehme, Christian, Khader, Yasmin, Ghanim, Marcel, Sheikh, Taha, Alhmoud, Tarik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Shaheed Beheshti University of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101516/
https://www.ncbi.nlm.nih.gov/pubmed/33968346
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author Ghazaleh, Sami
Hindupur, Anay
Nehme, Christian
Khader, Yasmin
Ghanim, Marcel
Sheikh, Taha
Alhmoud, Tarik
author_facet Ghazaleh, Sami
Hindupur, Anay
Nehme, Christian
Khader, Yasmin
Ghanim, Marcel
Sheikh, Taha
Alhmoud, Tarik
author_sort Ghazaleh, Sami
collection PubMed
description Dysphagia is a symptom with a broad differential diagnosis. Usually, the etiology of dysphagia is benign, but it is essential to rule out serious causes. It is also critical to think outside the box when the etiology is not obvious. Herein, we describe a case of multiple myeloma that initially presented with dysphagia. An 81-year-old male patient presented with dysphagia to solid food associated with anorexia and weight loss of 22 kg over the last 6 months. The patient looked chronically ill and cachectic. Upper endoscopy showed patchy erythema in the gastric antrum. Gastric biopsy was consistent with gastric amyloidosis. Although serum and urine protein electrophoresis did not show a monoclonal (M) band, immunofixation did show elevated free kappa light chains and elevated free Kappa/Lambda ratio. Bone marrow biopsy was consistent with multiple myeloma. Although gastrointestinal involvement is common in amyloidosis, it is unusual for amyloidosis to initially present in the gastrointestinal tract. Identification and treatment of the underlying condition, e.g., multiple myeloma, can lead to regression of gastrointestinal amyloidosis.
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spelling pubmed-81015162021-05-07 Gastric amyloidosis in a patient with dysphagia Ghazaleh, Sami Hindupur, Anay Nehme, Christian Khader, Yasmin Ghanim, Marcel Sheikh, Taha Alhmoud, Tarik Gastroenterol Hepatol Bed Bench Case Report Dysphagia is a symptom with a broad differential diagnosis. Usually, the etiology of dysphagia is benign, but it is essential to rule out serious causes. It is also critical to think outside the box when the etiology is not obvious. Herein, we describe a case of multiple myeloma that initially presented with dysphagia. An 81-year-old male patient presented with dysphagia to solid food associated with anorexia and weight loss of 22 kg over the last 6 months. The patient looked chronically ill and cachectic. Upper endoscopy showed patchy erythema in the gastric antrum. Gastric biopsy was consistent with gastric amyloidosis. Although serum and urine protein electrophoresis did not show a monoclonal (M) band, immunofixation did show elevated free kappa light chains and elevated free Kappa/Lambda ratio. Bone marrow biopsy was consistent with multiple myeloma. Although gastrointestinal involvement is common in amyloidosis, it is unusual for amyloidosis to initially present in the gastrointestinal tract. Identification and treatment of the underlying condition, e.g., multiple myeloma, can lead to regression of gastrointestinal amyloidosis. Shaheed Beheshti University of Medical Sciences 2021 /pmc/articles/PMC8101516/ /pubmed/33968346 Text en ©2021 RIGLD, Research Institute for Gastroenterology and Liver Diseases https://creativecommons.org/licenses/by/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/ (https://creativecommons.org/licenses/by/3.0/) ) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Ghazaleh, Sami
Hindupur, Anay
Nehme, Christian
Khader, Yasmin
Ghanim, Marcel
Sheikh, Taha
Alhmoud, Tarik
Gastric amyloidosis in a patient with dysphagia
title Gastric amyloidosis in a patient with dysphagia
title_full Gastric amyloidosis in a patient with dysphagia
title_fullStr Gastric amyloidosis in a patient with dysphagia
title_full_unstemmed Gastric amyloidosis in a patient with dysphagia
title_short Gastric amyloidosis in a patient with dysphagia
title_sort gastric amyloidosis in a patient with dysphagia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101516/
https://www.ncbi.nlm.nih.gov/pubmed/33968346
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