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Saeed Alshehri
KSA
Posters & Accepted Abstracts: J Hepato Gastroenterol
Background: Primary localized amyloidosis of the intestine is a rare entity. It is characterized by isolated deposition of amyloid proteins. Its clinical, colonoscopic, and radiological features masquerade several conditions such as ischemic colitis, infarction, polyps, and malignant tumors. Objectives: We conducted a comprehensive search of the published literature (1960 to 2019) to make an updated evaluation of the clinicopathologic and colonoscopic features of this entity. Data sources: A literature review of case reports of localized intestinal amyloidosis by searching literature (PubMed data base). We used several keywords: "amyloidosis" and "small intestine" or “ileum” or “jejunum” or “colon”. Studyselection: We identified756 studies about gastrointestinal amyloidosis. Data extraction and synthesis: Data were examined for 25 cases of localized intestinal amyloidosis. Main outcomes and measures: The clinicopathologic and endoscopic features were described. Results: In localized intestinal amyloidosis, the age at presentation ranged from 29 years to 88 years. The male to female ratio was about 3 to 1.The jejunum and rectosigmoid were commonly involved. Abdominal pain and intestinal obstruction (amyloidosis of the small intestine), or rectal bleeding and abdominal pain (amyloidosis of the rectosigmoid regions) were the most common clinical presentations. Colonoscopic findings included wall thickening, and mucosal ulcerations (amyloidosis of the small intestine) and tumor-like masses (amyloidosis of the colorectum). Amyloid deposits consisted of AL or light chain proteins. Conclusions: Primary localized intestinal amyloidosis is a rare condition. Its clinical outcome depends on the site of deposition of the amyloid (mucosa, submucosa, muscle layers, blood vessels, or nerves). Its non-specific symptoms are responsible for its missed and delayed diagnosis.
