Document Detail


Primary systemic amyloidosis: a cause of malabsorption syndrome.
MedLine Citation:
PMID:  11705429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Although malabsorption syndrome is encountered frequently by general internists and gastroenterologists and is common to various underlying disease processes, primary amyloidosis is often overlooked during medical evaluation. We describe the diagnosis, natural history, and laboratory features of a subgroup of patients with primary amyloidosis who presented predominantly with gastrointestinal symptoms and with evidence of a malabsorption syndrome. SUBJECTS AND METHODS: We reviewed all patients diagnosed with amyloidosis and malabsorption syndrome who had been seen at the Mayo Clinic from 1960 through 1998. Nineteen patients with small bowel biopsy results showing primary amyloid and with laboratory evidence of a malabsorption syndrome were studied. RESULTS: The most common symptoms were diarrhea or steatorrhea in 95% of patients (n = 18), anorexia in 42% (n = 8), and dizziness in 32% (n = 6). The most common signs included weight loss in all 19 patients, with a median weight loss of 30 pounds (range, 2 to 134 pounds) and hypotension or orthostatic changes in 10 patients (53%). The median time from symptom onset to diagnosis was 7 months. Most patients had evidence of amyloid involvement of other organs. Only 3 patients (16%) were diagnosed correctly upon initial presentation. Serum or urine protein electrophoresis results were positive in 95% of patients (n = 18). Median survival was 11 months from histologic diagnosis. CONCLUSIONS: Primary systemic amyloidosis should be considered in the differential diagnosis of malabsorption syndrome. All patients over 30 years of age with a malabsorption syndrome should have screening serum and urine immunofixation before undergoing a small bowel biopsy.
Authors:
S R Hayman; M Q Lacy; R A Kyle; M A Gertz
Related Documents :
21396679 - Heterogeneous pattern of renal disease associated with homozygous factor h deficiency.
23992369 - Use of thromboelastography and thrombin generation assay to predict clinical phenotype ...
21352419 - Inaccuracies in estimated glomerular filtration rate (egfr) in one australian renal cen...
19358059 - Small-bowel diagnosis in patients with familial adenomatous polyposis: comparison of pu...
24499079 - Rate of ankle-brachial index decline predicts cardiovascular mortality in hemodialysis ...
4532969 - Hyperphagia in intestinal disease.
18616439 - Predictive value of t-wave abnormalities at the time of emergency department presentati...
22187059 - Decreased vitamin d levels in patients with familial mediterranean fever.
3184289 - Gastrocystoplasty: an alternative solution to the problem of urological reconstruction ...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  111     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-13     Completed Date:  2001-12-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  535-40     Citation Subset:  AIM; IM    
Affiliation:
Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amyloidosis / complications*
Female
Hemoglobins / analysis
Humans
Malabsorption Syndromes / diagnosis,  etiology*
Male
Middle Aged
Prognosis
Retrospective Studies
Grant Support
ID/Acronym/Agency:
CA 62242/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Hemoglobins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The epidemiology of nephrotoxicity associated with conventional amphotericin B therapy.
Next Document:  Risk of hospitalization resulting from upper gastrointestinal bleeding among patients taking cortico...