Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Nov 27;6(11):e00289.
doi: 10.14309/crj.0000000000000289. eCollection 2019 Nov.

Colonoscopy Leading to the Diagnosis of AL Amyloidosis in the Gastrointestinal Tract Mimicking an Acute Ulcerative Colitis Flare

Brian S Lee  1 , Yuvrajsinh Chudasama  2 , Adam I Chen  1   2 , Brian S Lim  1   2 , Mark T Taira  3
Affiliations
Case Reports

Colonoscopy Leading to the Diagnosis of AL Amyloidosis in the Gastrointestinal Tract Mimicking an Acute Ulcerative Colitis Flare

Brian S Lee et al. ACG Case Rep J. .

Abstract

The 2 most common types of amyloidosis are light chain (AL) and reactive (AA). AL is associated with plasma cell dyscrasias; reactive (AA) is associated with chronic inflammatory conditions. A few cases have described AL amyloidosis mimicking colitis. However, endoscopic findings leading to the diagnosis of AL amyloidosis are rare. We report a 77-year-old woman with a medical history of ulcerative colitis who presented with recurrent nonbloody watery diarrhea. Colonoscopy revealed features suspicious for amyloidosis. Bone marrow biopsy showed multiple myeloma and AL amyloidosis. This case demonstrates the importance of generating a broad differential and the pivotal role of endoscopic findings in diagnosing uncommon diseases.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Colonoscopy showing (A) extensive submucosal hemorrhage and (B) purplish blebs in the sigmoid colon.
Figure 2.
Figure 2.
Biopsy of the colon specimen showing (A) amyloid deposits without polarization and (B) apple-green birefringence of amyloid deposits after Congo red staining.
Figure 3.
Figure 3.
Biopsy of the bone marrow showing amyloid deposits after Congo red staining.
See this image and copyright information in PMC

References

    1. Ebert EC, Nagar M. Gastrointestinal manifestations of amyloidosis. Am J Gastroenterol. 2008;103(3):776–87. - PubMed
    1. Merlini G, Bellotti V. Molecular mechanisms of amyloidosis. N Engl J Med. 2003;349(6):583–96. - PubMed
    1. Kanuru R, Stanich PP, Meyer MM. Colonic complications from gastrointestinal amyloidosis. Austin J Gastroenterol. 2014;1(5):1023.
    1. Casad DE, Bocian JJ. Primary systemic amyloidosis simulating acute idiopathic ulcerative colitis: Report of a case. Am J Dig Dis. 1965;10:63–74. - PubMed
    1. Rahman N, Toqeer M, Hawley I, et al. Primary systemic amyloidosis presenting as idiopathic inflammatory colitis. BMJ Case Rep. 2011;2011:bcr0820114596. - PMC - PubMed

Publication types