Amyloidosis is defined as the extracellular deposition of non-branching fibrils composed of a variety of serum-protein precursors. Secondary amyloidosis is associated with several chronic inflammatory conditions, such as rheumatologic or intestinal diseases, familial Mediterranean fever, or chronic infectious diseases, such as tuberculosis. Although the association of amyloidosis with inflammatory bowel disease is known, amyloidosis secondary to ulcerative colitis (UC) is rare. A 36-year-old male patient with a 15-year history of UC presented with nausea, vomiting, and abdominal pain. He had been treated with infliximab for 6 years. At the time of admission, he had been undergoing treatment with mesalazine and adalimumab since the preceding 5 months. Esophagogastroduodenoscopy showed mucosal erythema, edema, and erosions with geographic ulcers at the 2nd and 3rd portions of the duodenum. Duodenal amyloidosis was diagnosed using polarized light microscopy and Congo red stain. Monoclonal gammopathy was not detected in serum and urine tests, while the serum free light chain assay result was not specific. An increase in plasma cells in the bone marrow was not found. Secondary amyloidosis due to UC was suspected. The symptoms were resolved after glucocorticoid therapy.

Citations

Citations to this article as recorded by  

• Idiopathic AA amyloidosis presenting with initial abdominal pain: a case report and literature review
  Pianpian Xia, Deliang Liu, Feihong Deng, Dalian Ou, Mingyang Deng
  Frontiers in Medicine.2025;[Epub]     CrossRef
• Gastrointestinal amyloidosis in a 50‐year‐old patient with miliary tuberculosis: A case report
  Sameer Abdul Rauf, Hussain Haider Shah, Rahul Khatri, Mansoor Ul Haq, Tirth Dave, Javaria Parwez Ali, Syed Khizar Ali
  Clinical Case Reports.2024;[Epub]     CrossRef
• Therapeutic effects of biological treatments on AA amyloidosis associated with inflammatory bowel disease: a case report and literature review
  Marouf Alhalabi, Kamal Alaa Eddin, Ahmad Abbas
  European Journal of Gastroenterology & Hepatology.2023; 35(11): 1298.     CrossRef
• Rheumatoid arthritis: Extra-articular manifestations and comorbidities
  Fabiana Assunta Figus, Matteo Piga, Irene Azzolin, Rebecca McConnell, Annamaria Iagnocco
  Autoimmunity Reviews.2021; 20(4): 102776.     CrossRef
• Specific Clinical and Morphological Characteristics of Amyloidosis of the Stomach and Duodenum
  Z. V. Gioeva, L. M. Mikhaleva
  Journal of Anatomy and Histopathology.2019; 8(1): 39.     CrossRef
• Morphological and Immunohistochemical Characteristics of Experimental Mandibular Fractures Healing Process
  A. A. Matchin, A. A. Stadnikov, E. V. Nosov, S. Kh. Kiriakidi
  Journal of Anatomy and Histopathology.2019; 8(1): 44.     CrossRef
• Secondary, AA, Amyloidosis
  Riccardo Papa, Helen J. Lachmann
  Rheumatic Disease Clinics of North America.2018; 44(4): 585.     CrossRef

Amyloidosis is characterized by the abnormal deposition of extracellular amyloid fibrils. Cases involving amyloid light-chain amyloidosis in the small intestine have been reported infrequently in Korea. Here, we report a case of localized light chain protein amyloidosis in the small intestine. Esophagogastroduodenoscopy, push enteroscopy, and capsule endoscopy revealed submucosal tumor-like lesions, multiple shallow ulcers, and several erosions in the distal duodenum and jejunum. An endoscopic biopsy established the diagnosis of amyloidosis. In through an immunohistochemical analysis, the presence of lambda light chain protein was detected. The patient had no evidence of an underlying clonal plasma cell disorder or additional organ involvement. Therefore, we concluded that the patient had localized amyloidosis of the small intestine.

Citations

Citations to this article as recorded by  

• A systematic review of the literature on localized gastrointestinal tract amyloidosis: Presentation, management and outcomes
  Mariuxi Alexandra Viteri Malone, David Alfonso Alejos Castillo, Heitor Tavares Santos, Anahat Kaur, Tarek Elrafei, Lewis Steinberg, Abhishek Kumar
  European Journal of Haematology.2024; 113(4): 400.     CrossRef
• Iatrogenic Sigma Perforation in a Patient with Localized Rectal and Sigma AL Amyloidosis: A Forensic Case and a Literature Review
  Giuseppe Davide Albano, Stefania Zerbo, Simone Di Franco, Elisabetta Orlando, Eleonora Formisano, Antonina Argo, Beatrice Belmonte
  Forensic Sciences.2024; 4(3): 453.     CrossRef
• Systemic Immunoglobulin Light Chain Amyloidosis Involving the Large Intestine
  Renugadevi Swaminathan, Samuel Igbinedion, Sudha Pandit
  ACG Case Reports Journal.2021; 8(5): e00578.     CrossRef
• Unusual case of amyloidosis presenting as a jejunal mass
  Sachin Mohan, Elliot Graziano, James Campbell, Irshad H Jafri
  BMJ Case Reports.2021; 14(5): e240226.     CrossRef
• Gastrointestinal AA amyloidosis secondary to chronic pyelonephritis presenting with refractory diarrhea and severe hypoalbuminemia
  Tomoko Tanaka, Tatsushi Naito, Yohei Midori, Takuto Nosaka, Kazuto Takahashi, Kazuya Ofuji, Hidetaka Matsuda, Masahiro Ohtani, Katsushi Hiramatsu, Yoshiaki Imamura, Osamu Yokoyama, Hironobu Naiki, Yasunari Nakamoto
  Clinical Journal of Gastroenterology.2021; 14(6): 1642.     CrossRef
• Morphological and Immunohistochemical Characteristics of Experimental Mandibular Fractures Healing Process
  A. A. Matchin, A. A. Stadnikov, E. V. Nosov, S. Kh. Kiriakidi
  Journal of Anatomy and Histopathology.2019; 8(1): 44.     CrossRef
• Specific Clinical and Morphological Characteristics of Amyloidosis of the Stomach and Duodenum
  Z. V. Gioeva, L. M. Mikhaleva
  Journal of Anatomy and Histopathology.2019; 8(1): 39.     CrossRef
• Localized Gastrointestinal ALλ Amyloidosis
  Tomoya Iida, Kentaro Yamashita, Hiroshi Nakase
  Clinical Gastroenterology and Hepatology.2018; 16(9): e93.     CrossRef
• Small Bowel Amyloidosis
  Raghav Bansal, Umer Syed, Jacob Walfish, Joshua Aron, Aaron Walfish
  Current Gastroenterology Reports.2018;[Epub]     CrossRef
• Systemic amyloidosis with gastrointestinal involvement: Diagnosis from endoscopic and histological views
  Tomoya Iida, Hiroo Yamano, Hiroshi Nakase
  Journal of Gastroenterology and Hepatology.2018; 33(3): 583.     CrossRef