Year 2023 / Volume 115 / Number 2
Letter
Systemic amyloidosis as a cause of chronic diarrhea after gastric surgery. Literature review

93-94

DOI: 10.17235/reed.2022.8971/2022

Rocío Forneiro Pérez, Juan Alfredo Ubiña Martínez, Inmaculada Lendínez Romero,

Abstract
Amyloidosis with gastrointestinal involvement is a rare cause of chronic diarrhoea, and should be considered especially in adult patients with intestinal malabsorption and extra GI manifestations. We present the case of a male patient who, after an oncological gastrectomy, presented with chronic diarrhea that did not respond to treatment and, after study, the cause of the diarrhea was finally found. Primary systemic light chain amyloidosis (AL) initially presents as chronic diarrhea and weight loss after gastrectomy. Immunohistochemistry was completely negative for amyloid A, which virtually rules out AA amyloidosis. With regard to the immunoglobulin chains, an amyloid signal was observed for both light chains, with a predominance of lambda light chain but not entirely conclusive. This situation is not uncommon since amyloid, whatever its chemical nature, can annex serum proteins, including immunoglobulin chains. In the case of chronic diarrhea, the possibility of amyloidosis should be kept in mind, especially in the case of weight loss.
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References
1. Davis JL, Ripley RT. Postgastrectomy Syndromes and Nutritional Considerations Following Gastric Surgery. Surg Clin North Am [Internet]. 2017;97(2):277–93. Available from: http://dx.doi.org/10.1016/j.suc.2016.11.005
2. Talar-Wojnarowska R, Jamroziak K. Intestinal amyloidosis: Clinical manifestations and diagnostic challenge [Internet]. Vol. 30, Advances in Clinical and Experimental Medicine. Adv Clin Exp Med; 2021 [cited 2021 Dec 11]. Available from: https://pubmed.ncbi.nlm.nih.gov/33974753/
3. Iida T, Yamano H, Nakase H. Systemic amyloidosis with gastrointestinal involvement: Diagnosis from endoscopic and histological views. J Gastroenterol Hepatol. 2018;33(3):583–90.
4. De-feng Li, Jun Yao, Li-sheng Wang. Ileal amyloidosis mimicking Crohn´s disease as a cause of chronic diarrhea Keywords: Rev Española Enfermedades Dig. 2021;113(12):855–6.
5. Palladini G, Milani P, Merlini G. Management of AL amyloidosis in 2020 [Internet]. Vol. 136, Blood. American Society of Hematology; 2020 [cited 2021 Nov 24]. p. 2620–7. Available from: http://ashpublications.org/blood/article-pdf/136/23/2620/1791826/bloodbld2020006913c.pdf
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Forneiro Pérez R, Ubiña Martínez J, Lendínez Romero I. Systemic amyloidosis as a cause of chronic diarrhea after gastric surgery. Literature review. 8971/2022


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Publication history

Received: 28/05/2022

Accepted: 06/06/2022

Online First: 24/06/2022

Published: 07/02/2023

Article Online First time: 27 days

Article editing time: 255 days


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