Document Detail

Primary (AL) amyloidosis with gastrointestinal involvement.
MedLine Citation:
PMID:  19242859     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Immunoglobulin light-chain (AL) amyloidosis is a rare disease that can affect several organs. The aim of this study was to characterize patients with gastrointestinal manifestations of AL amyloidosis, in terms of symptoms, biochemistry, and outcome. MATERIAL AND METHODS: Retrospectively, patients with AL amyloidosis admitted for evaluation of malabsorption in a Department of Gastroenterology between January 2000 and December 2006 were identified. RESULTS: A total of 11 patients (4 F, age 60 years, median (range) 50-69) were included in the study. Gastrointestinal amyloidosis was histologically verified in all patients. All patients had gastrointestinal symptoms, 8 of them prior to establishment of diagnosis. Median (range) delay from initial symptoms to diagnosis was 7 (0-24) months. The most prominent symptom was weight loss (n=10) averaging 7 (0-25) kg, followed by diarrhea (n=5). Steatorrhea (2 mild, 1 moderate, 1 severe) was found in 4 of 7 patients examined. At presentation, 9 patients had hypoalbuminemia and 6 patients had anemia. Three patients were treated with home parenteral nutrition. Five patients received conventional chemotherapy (oral melphalan and prednisone) and 5 patients underwent high-dose melphalan and autologous stem-cell transplantation. Five patients died within the observation period, at a median of 10 (3-36) months after the diagnosis was established. Non-survivors tended to have lower albumin levels on admission and more involvement of other organs compared to survivors. CONCLUSIONS: Most patients with gastrointestinal AL amyloidosis experience weight loss and all have signs of malabsorption. Despite treatment the prognosis is grave.
Lone Galmstrup Madsen; Peter Gimsing; Frank V Schiødt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  44     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-05-19     Completed Date:  2009-10-08     Revised Date:  2009-11-06    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  708-11     Citation Subset:  IM    
Department of Gastroenterology, Rigshospitalet, Copenhagen, Denmark.
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MeSH Terms
Amyloidosis / pathology*
Gastrointestinal Diseases / pathology*
Immunoglobulin Light Chains*
Malabsorption Syndromes / pathology
Middle Aged
Retrospective Studies
Reg. No./Substance:
0/Immunoglobulin Light Chains
Comment In:
Scand J Gastroenterol. 2009;44(11):1384-5   [PMID:  19891590 ]

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