Tags

Type your tag names separated by a space and hit enter

Dysphagia unveiling systemic immunoglobulin light-chain amyloidosis with multiple myeloma.
BMJ Case Rep. 2018 Oct 21; 2018BC

Abstract

Dysphagia is an uncommon presentation of systemic immunoglobulin light-chain (AL) amyloidosis with multiple myeloma (MM). Gastrointestinal (GI) involvement usually manifests with altered motility, malabsorption or bleeding. Furthermore, patients identified with GI amyloidosis, without previous diagnosis of a plasma cell disorder, are extremely rare. We report an elderly woman who presented with acute on chronic cardiac dysfunction, sick sinus syndrome and acute renal failure. While admitted, she developed intermittent dysphagia to both solids and liquids. Oesophagogastroduodenoscopy showed ulcerations of oesophagus and duodenum. Biopsies revealed focal amyloid deposition, stained with Congo red. Renal biopsy revealed amyloid deposition in renal arterioles. She underwent a bone marrow biopsy confirming MM, represented by more than 15% plasma cell population. She was started on treatment for heart failure, induction chemotherapy for MM and percutaneous gastrostomy tube for feeding. However, she continued to deteriorate, eventually opting for hospice, and ultimately died 2 days after discharge from hospital.

Authors+Show Affiliations

Internal Medicine, McLaren Health Care Corp, Flint, Michigan, USA.Internal Medicine, McLaren Health Care Corp, Flint, Michigan, USA.Internal Medicine, McLaren Health Care Corp, Flint, Michigan, USA.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30344148

Citation

Gonzalez, Juan, et al. "Dysphagia Unveiling Systemic Immunoglobulin Light-chain Amyloidosis With Multiple Myeloma." BMJ Case Reports, vol. 2018, 2018.
Gonzalez J, Wahab A, Kesari K. Dysphagia unveiling systemic immunoglobulin light-chain amyloidosis with multiple myeloma. BMJ Case Rep. 2018;2018.
Gonzalez, J., Wahab, A., & Kesari, K. (2018). Dysphagia unveiling systemic immunoglobulin light-chain amyloidosis with multiple myeloma. BMJ Case Reports, 2018. https://doi.org/10.1136/bcr-2018-226331
Gonzalez J, Wahab A, Kesari K. Dysphagia Unveiling Systemic Immunoglobulin Light-chain Amyloidosis With Multiple Myeloma. BMJ Case Rep. 2018 Oct 21;2018 PubMed PMID: 30344148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dysphagia unveiling systemic immunoglobulin light-chain amyloidosis with multiple myeloma. AU - Gonzalez,Juan, AU - Wahab,Ahsan, AU - Kesari,Kavitha, Y1 - 2018/10/21/ PY - 2018/10/23/entrez PY - 2018/10/23/pubmed PY - 2019/1/27/medline KW - endoscopy KW - gastrointestinal system KW - heart failure JF - BMJ case reports JO - BMJ Case Rep VL - 2018 N2 - Dysphagia is an uncommon presentation of systemic immunoglobulin light-chain (AL) amyloidosis with multiple myeloma (MM). Gastrointestinal (GI) involvement usually manifests with altered motility, malabsorption or bleeding. Furthermore, patients identified with GI amyloidosis, without previous diagnosis of a plasma cell disorder, are extremely rare. We report an elderly woman who presented with acute on chronic cardiac dysfunction, sick sinus syndrome and acute renal failure. While admitted, she developed intermittent dysphagia to both solids and liquids. Oesophagogastroduodenoscopy showed ulcerations of oesophagus and duodenum. Biopsies revealed focal amyloid deposition, stained with Congo red. Renal biopsy revealed amyloid deposition in renal arterioles. She underwent a bone marrow biopsy confirming MM, represented by more than 15% plasma cell population. She was started on treatment for heart failure, induction chemotherapy for MM and percutaneous gastrostomy tube for feeding. However, she continued to deteriorate, eventually opting for hospice, and ultimately died 2 days after discharge from hospital. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/30344148/Dysphagia_unveiling_systemic_immunoglobulin_light_chain_amyloidosis_with_multiple_myeloma_ L2 - https://casereports.bmj.com/lookup/pmidlookup?view=long&pmid=30344148 DB - PRIME DP - Unbound Medicine ER -