A rare cause of dysphagia and gastroparesis

An 82-year-old woman was admitted with severe vomiting and progressive dysphagia mainly to solids. She gave a 3-month history of increasing heartburn, vomiting, tiredness, lethargy, anorexia and 13 kg weight loss. Her past medical history was unremarkable and she was a non-smoker. Physical examinati...

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Bibliographic Details
Published in:BMJ case reports 2009, Vol.2009 (apr14 1), p.bcr0720080358-bcr0720080358
Main Authors: Basavaraju, Krishna Prakash, Mansour, Dina, Barnes, Stuart, Whitehead, Mark W, Bruce, Stuart A
Format: Article
Language:English
Subjects:
80 Years
Biopsy
Disease
Dysphagia
Europe (West)
Family medical history
Female
Medical prognosis
Nutrition
Parenteral nutrition
Proteins
Unusual Association of Diseases/Symptoms
White
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Summary:An 82-year-old woman was admitted with severe vomiting and progressive dysphagia mainly to solids. She gave a 3-month history of increasing heartburn, vomiting, tiredness, lethargy, anorexia and 13 kg weight loss. Her past medical history was unremarkable and she was a non-smoker. Physical examination revealed evidence of significant weight loss and dehydration only. Gastroscopy revealed mild oesophagitis, tongues of Barrett oesophagus and mild antral gastritis. CT scan of the thorax and abdomen was normal. Unfortunately her condition deteriorated rapidly and she died from aspiration pneumonia. Postmortem examination revealed thickening of the muscular wall of lower oesophagus and pylorus, but without any malignancy. The histological assessment of the oesophageal as well as gastric biopsies confirmed the diagnosis of gastrointestinal amyloidosis accounting for her symptoms of dysphagia and vomiting respectively.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.07.2008.0358