Gastrointestinal amyloidosis

Changed by Aanand Vibhakar, 1 Sep 2018

Updates to Article Attributes

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Gastrointestinal amyloidosis is relatively common, although symptomatic involvement is more rare. It is diagnosed if there is persistent gastrointestinal (GI) symptoms with endoscopic biopsy proven amyloid deposition.

Epidemiology

Tends to affect middle-aged and older patients. 

Clinical presentation

Weight loss (most common) and GI bleeding are the main symptoms. Other symptoms include gastro-oesophageal reflux, constipation, nausea, diarrhea, weight loss, early satiety, and abdominal pain.

Pathology

Location
  • duodenum (most common)
  • stomach (second most common): the gastric manifestations of amyloidosis include gastric fold and or wall thickening and rigidity. Luminal narrowing can cause a linitis plastica type appearance and mimic gastric carcinoma.
  • colon and rectum
  • oesophagus

Radiographic features

Fluoroscopy

Stomach: thickened folds, which may appear nodular or mass-like and which may contain calcifications

CT

Features include:

  • diffuse wall thickening of the involved segment of bowel
  • intussusception
  • dilatation depending upon the degree of hypomotility; GI bleeding can also cause dilated bowel loops with fluid levels
  • luminal narrowing either due to amyloid infiltration or secondary to ischemia

Differential diagnosis

  • infectious enteritis (e.g. Shigella, Salmonella, Escherichia coli, cytomegalovirus, Cryptococcus, pseudomembranous colitis, AIDS)
  • bowel ischaemia
  • other infiltrating process, e.g. small bowel lymphoma
  • other causes of GI bleeding

See also

  • -<a href="/articles/stomach">stomach</a> (second most common)</li>
  • +<a href="/articles/stomach">stomach</a> (second most common): the gastric manifestations of amyloidosis include gastric fold and or wall thickening and rigidity. Luminal narrowing can cause a linitis plastica type appearance and mimic gastric carcinoma.</li>
  • -</ul><h4>Radiographic features</h4><h5>CT</h5><p>Features include:</p><ul>
  • +</ul><h4>Radiographic features</h4><h5>Fluoroscopy</h5><p>Stomach: thickened folds, which may appear nodular or mass-like and which may contain calcifications</p><h5>CT</h5><p>Features include:</p><ul>

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