Gabriel Heering, Zilan Lin, Michael Rosman, Nao Hara, Fouzia Shakil, Dimitrios Georgostathis
{"title":"Side Effects of Stem Cell Transplant Mimicking Symptoms of Known Amyloidosis.","authors":"Gabriel Heering, Zilan Lin, Michael Rosman, Nao Hara, Fouzia Shakil, Dimitrios Georgostathis","doi":"10.1159/000538947","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>AL amyloidosis can involve the gastrointestinal (GI) tract in a sporadic manner, affecting certain anatomical areas while sparing others.</p><p><strong>Case presentation: </strong>Our patient with AL amyloidosis and confirmed colonic involvement was found to have new odynophagia, GI bleeding, and imaging findings that might suggest AL amyloidosis. However, negative pathology results from esophageal biopsies suggested the patient's new ulcerations were more likely a side effect of her autologous stem cell transplant (SCT) and chemotherapy meant to target amyloidosis, as opposed to an effect of amyloid infiltration itself.</p><p><strong>Conclusion: </strong>GI involvement of amyloidosis requires a high degree of clinical suspicion and should be considered in patients with systemic diseases affecting the kidney, heart, and GI tract; however, when satisfactory biopsies obtained from endoscopy results are negative, other causes should be considered.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"18 1","pages":"273-278"},"PeriodicalIF":0.5000,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175601/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000538947","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: AL amyloidosis can involve the gastrointestinal (GI) tract in a sporadic manner, affecting certain anatomical areas while sparing others.
Case presentation: Our patient with AL amyloidosis and confirmed colonic involvement was found to have new odynophagia, GI bleeding, and imaging findings that might suggest AL amyloidosis. However, negative pathology results from esophageal biopsies suggested the patient's new ulcerations were more likely a side effect of her autologous stem cell transplant (SCT) and chemotherapy meant to target amyloidosis, as opposed to an effect of amyloid infiltration itself.
Conclusion: GI involvement of amyloidosis requires a high degree of clinical suspicion and should be considered in patients with systemic diseases affecting the kidney, heart, and GI tract; however, when satisfactory biopsies obtained from endoscopy results are negative, other causes should be considered.
导言:AL淀粉样变性可能以散发性方式累及胃肠道(GI),影响某些解剖区域,而其他区域则不受影响:我们的患者患有 AL 淀粉样变性并确诊为结肠受累,但发现新的吞咽困难、消化道出血和影像学检查结果可能提示 AL 淀粉样变性。然而,食管活检的阴性病理结果表明,患者的新溃疡更可能是自体干细胞移植(SCT)和针对淀粉样变性的化疗的副作用,而非淀粉样变性浸润本身的影响:结论:临床上需要高度怀疑淀粉样变性的消化道受累,如果患者患有影响肾脏、心脏和消化道的全身性疾病,则应考虑淀粉样变性的消化道受累。