Emerging from the shadows: A rare case of gastrointestinal AL amyloidosis presenting as hematemesis

We document a unique presentation of light chain (AL) amyloidosis in a 62-year-old man exhibiting as acute hematemesis and chronic abdominal discomfort. Esophagogastroduodenoscopy disclosed marked thickening of gastric and duodenal folds, gastroduodenal nodularity, and friable ulcerations. Biopsy co...

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Published in:Proceedings - Baylor University. Medical Center 2023, Vol.36 (6), p.758-760
Main Authors: Jaan, Ali, Sarfraz, Zouina, McFarland, Joel, Okolo, Patrick, Dunnigan, Karin, Gutman, Jason
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Case reports
Clinician’s Corner
Gastrointestinal diseases
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Sarfraz, Zouina
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Gutman, Jason
description We document a unique presentation of light chain (AL) amyloidosis in a 62-year-old man exhibiting as acute hematemesis and chronic abdominal discomfort. Esophagogastroduodenoscopy disclosed marked thickening of gastric and duodenal folds, gastroduodenal nodularity, and friable ulcerations. Biopsy confirmed amyloidosis. Subsequent investigations ratified a diagnosis of systemic AL amyloidosis with cardiac involvement. Initiation of the cyclophosphamide, bortezomib, and dexamethasone (CyBorD) regimen, along with tafamidis and doxycycline for cardiac pathology, led to substantial improvement of abdominal symptoms. This case highlights the variability in amyloidosis presentations and the importance of early diagnosis.
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subjects Case reports
Clinician’s Corner
Gastrointestinal diseases
title Emerging from the shadows: A rare case of gastrointestinal AL amyloidosis presenting as hematemesis
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