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Renal amyloidosis as a late complication of Crohn's disease:a case report and review of the literature from Japan

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World Journal of Gastroenterology 2000年第3期6卷 461-464页

作者： Osamu Saitoh Keishi Kojima Tsutomu Teranishi Ken Nakagawa Masanobu Kayazawa Masashi Nanri Yutaro Egashira Ichiro Hirata Ken-ichi Katsu Second Department of Internal Medicine Osaka Medical CollegeTakatsukiJapan First Department of Pathology Osaka Medical CollegeTakatsukiJapan

INTRODUCTION Secondary amyloidosis is a rare but seriouscomplication of Crohn’s disease(CD).Theincidence of the association of secondaryamyloidosis in patients with CD has been reportedto be 0.5%-8% in Western ***,in Japan,the number of patients with CDcomplicated by amyloidosis is *** of their clinical manifestations andthe incidence of association are ***,we report herein a patient with

关键词： Crohn’s disease/complication renal amyloidosis amyloid deposits

Hepatic amyloidosis leading to hepatic venular occlusive disease and Budd-Chiari syndrome: A case report

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World Journal of Clinical Cases 2019年第20期7卷 3282-3288页

作者： Ting-Ting Li Yi-Fan Wu Fu-Quan Liu Fu-Liang He Department of Interventional Therapy Beijing Shijitan Hospital Capital Medical University The 9th Affiliated Hospital of Peking University

BACKGROUND Systemic amyloidosis in which multiple systems can be involved has become a common clinical *** the liver is affected,symptoms such as abdominal distension,fatigue,edema,liver,and jaundice could *** date,hepatic amyloidosis combined with hepatic venular occlusive disease and Budd-Chiari syndrome has not been *** SUMMARY A 54-year-old female patient was admitted to the Beijing Shijitan Hospital with hepatic amyloidosis leading to hepatic venular occlusion and Budd-Chiari syndrome in *** patient underwent surgery 1 mo previously for liver rupture and hemorrhage after Budd-Chiari syndrome was *** was diagnosed with hepatic venular occlusion,liver amyloidosis,and Budd-Chiari syndrome(*** hepatic vein occlusion).Transjugular intrahepatic portosystem shunt was *** the treatment,the clinical symptoms improved markedly with increase in urine *** Hepatic amyloidosis with hepatic venous occlusion and Budd-Chiari syndrome is relatively rare clinically,and transjugular intrahepatic portosystem shunt is an effective treatment for this disease.

关键词： Hepatic venular occlusion Liver amyloidosis Budd-Chiari syndrome Portal hypertension Case report

Transthyretin Arg-83 mutation in vitreous amyloidosis

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International Journal of Ophthalmology(English edition) 2011年第3期4卷 329-331页

作者： Ling-Yan Chen, Weng-Lin Li Department of Ophthalmology Shenzhen Childrens' Hospital 7019 Yitian Road Shenzhen 518026 Guangdong Province China Key Laboratory of Ophthalmology of the Ministry of Education and Zhongshan Ophthalmic Center Sun Yat-sen University 54 Xianlie Road Guangzhou 510060 Guangdong Province China

Both of the patients in the report had floaters and progressive vision loss for years. Two cases of familial vitreous amyloidosis occurred in three generations with typical white fibrilar opacities in the vitreous body. Pars plana vitrectomy was performed in the two patients. The vitreous specimens were subjected to histopathological examination. The specimens showed typical microscopic features of amyloidosis with Congo red stain and non-branching fibrils were seen randomly distributed with 5-10nm in diameter on a transmission electron microscope. All of the exons of the transthyretin gene were amplified with DNA isolated from the peripheral blood cells. Bi-directional sequencing of the transthyretin gene revealed a single base-pair substitution, which results in an amino acid substitution at position83, glycine to arginine (transthyretin Arg-83).

关键词： vitreous amyloidosis transthyretin

Digitally reinforced hematoxylin-eosin polarization technique in diagnosis of rectal amyloidosis

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World Journal of Gastroenterology 2015年第6期21卷 1827-1837页

作者： Basak Doganavsargil Gulruh Emiroglu Buberal Huseyin Toz Banu Sarsik Burcin Pehlivanoglu Murat Sezak Sait Sen Depart-ment of Pathology Ege University Faculty of Medicine Department of Nephrology Ege University Faculty of Medicine

AIM:To investigate the efficacy of the digitally reinforced hematoxylin-eosin polarization(DRHEP)technique for detection of amyloidosis in rectal ***:One hundred hematoxylin-eosin(HE)stained rectal biopsies with Congo-red(CR)-positive amyloid depositions and 50 control cases with CRnegative amyloid-mimicking areas were scanned blinded to the CR results for amyloid depositions under both bright and polarized light,and digitally photographed using the DRHEP technique,to accentuate the faint birefringence observed in HE slides under *** results of DRHEP and HE evaluation were statistically correlated with CR polarization results with respect to presence and localization of amyloid deposits as well as amyloid ***:Amyloid deposits showed yellowish-green birefringence by DRHEP,which allowed identification of amyloidosis in 41 HE-unsuspected cases(P=0.016),31 of which only had vascular *** positivity was higher,and false negativity and positivity were lower by DRHEP,compared to evaluation by HE(69%,31%,and 0.8%vs 33%,67%,and 33%,respectively;P<0.0001).The sensitivity,specificity,accuracy,and positive and negative predictive values for DRHEP were69%,98%,78.6%,98.5%,and 61.25%,*** for DRHEP false negativity were presence of extensive background birefringence in 12 cases,absence of CR birefringent vessel in 3 cases,and missing of the tiny deposits in 9 cases,which could be improved by experience,especially in the latter *** correlation was found between age,gender,sites of deposits,or amyloid ***:The DRHEP technique improves diagnostic accuracy when used as an adjunct or a prior step to CR staining,especially for cases with limited tissues for further analysis.

关键词： amyloidosis Congo red Hematoxylin-eosin Microscopy

Case report and review of the literature of primary gastrointestinal amyloidosis diagnosed with enteroscopy and endoscopic ultrasonography

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World Journal of Clinical Cases 2018年第9期6卷 284-290页

作者： Yi-Pin Liu Wei-Wei Jiang Guo-Xun Chen Yan-Qing Li Department of Gastroenterology Qilu Hospital Shandong University Department of Gastroenterology Yantai Affiliated Hospital of Binzhou Medical University Department of Nutrition University of Tennessee

Here, we report a rare case of primary gastrointestinal amyloidosis in a stable condition after being followed up for three years. The patient was admitted to the hospital in 2014. Tests showed decreased levels of hemoglobin and ferritin. Transoral and transanal enteroscopy showed multiple nodular protuberances in the esophagus, ileum, colon and rectum. Endoscopic ultrasonography indicated the nodular protuberances stemmed from the submucosa and partially invaded the intrinsic myometrium. Pathological examinations found multiple small nodules in the submucosa and dyed structures, which were positive for special Congo red dyeing. After treatment with oral iron supplements, the levels of hemoglobin and ferritin became normal. It is concluded that the patient represents a case of primary gastrointestinal amyloidosis with multiple nodular protuberances in the digestive tract with controllable moderate abdominal discomfort and anemia and a benign course. Enteroscopy and endoscopic ultrasonography play an important role in the diagnosis of primary gastrointestinal amyloidosis.

关键词： Enteroscopy Primary gastrointestinal amyloidosis Endoscopic ultrasonography Pathological diagnosis

Mesenteric phlebosclerosis with amyloidosis in association with the long-term use of medicinal liquor: A case report

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World Journal of Clinical Cases 2020年第4期8卷 798-805页

作者： Yi-Bing Hu Min-Li Hu Jin Ding Qun-Ying Wang Xiao-Yun Yang Department of Gastroenterology and Hepatology Jinhua Municipal Central Hospital Jinhua Hospital of Zhejiang University

BACKGROUND Mesenteric phlebosclerosis(MP)is a rare disease of the *** clinical manifestations of this disease are nonspecific and it may easily be *** report a case of MP with amyloidosis in the colonic vessel walls in a patient with hypertension who had been consuming Chinese medicinal liquor for 10 *** also review the relevant literature and summarize the characteristics of MP in patients in China's *** SUMMARY A 64-year-old man was referred to our department from his primary hospital because of abdominal pain,diarrhea,and fever for almost 10 *** tomography showed colon wall thickening,with threadlike calcifications in the mesenteric vein in the transverse *** revealed purple-blue mucosa with multiple ulcers in the ascending and transverse *** showed thickening and calcification of the vein walls,perivascular and mucosal collagen degeneration,and *** patient had been consuming Chinese medicinal liquor,mainly that made from gardenia fruit,for 10 *** on these results,a diagnosis of MP with amyloidosis was *** conservative treatment,the patient’s discomfort subsided and he was followed *** use of Chinese herbal medicine was suspected to play a role in the pathogenesis of *** The clinical manifestations of MP are *** of its typical imaging findings,including multiple calcifications on computed tomography and purple-blue mucosal discoloration on colonoscopy,is vital.

关键词： Mesenteric phlebosclerosis amyloidosis Medicinal liquor Case report

Localized amyloidosis affecting the lacrimal sac managed by endoscopic surgery:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5684-5689页

作者： Xiao-Le Song Jing-Yi Yang Yu-Ting Lai Jia-Ying Zhou Jing-Jing Wang Xi-Cai Sun De-Hui Wang Department of Otorhinolaryngology EyeEarNoseand Throat HospitalFudan UniversityShanghai 200031China

BACKGROUND Here we present a rare case of localized amyloidosis involving the nasolacrimal duct and lacrimal sac which was managed by endoscopic *** SUMMARY A 50-year-old man whose medical history included bilateral ventricular fold and vocal cord amyloidosis complained of bilateral *** resonance imaging revealed a neoplasm within the nasolacrimal *** positivity for Congo red staining and birefringence under a polarized microscope proved the diagnosis of *** via an endoscope obtained a favorable result.A one-year follow-up found no *** There are few reports on amyloidosis involving the lacrimal outflow system,and management and outcome are not *** dacryocystorhinostomy can be a choice to relieve *** follow-up and monitoring of systemic diseases are highly recommended.

关键词： amyloidosis Nasolacrimal duct Nasolacrimal sac Endoscopy Dacryocystorhinostomy Case report

Cardiac amyloidosis: A case report and review of literature

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World Journal of Clinical Cases 2019年第6期7卷 742-752页

作者： Adeyemi Adedamola Taiwo Lavanya Alapati Assad Movahed Department of Internal Medicine East Carolina University Department of Cardiovascular Sciences East Carolina Heart InstituteEast Carolina University

BACKGROUND Cardiac amyloidosis,a disease caused by the precipitation of amyloid proteins in the myocardial extracellular matrix has been historically difficult to diagnose due to lack of specific clinical manifestations and necessity of biopsy to demonstrate amyloid deposition. However,advances in cardiovascular imaging techniques have facilitated earlier recognition of this disease. In addition,while once thought of as incurable,treatment strategies are emerging for cardiac amyloidosis,making early diagnosis *** SUMMARY We outline the case of a 73 years old African American female who was admitted with sudden onset shortness of breath and found to be in cardiogenic *** amyloidosis was suspected due to discordance between electrocardiogram and echocardiogram findings and this was subsequently confirmed with the aid of scintigraphy and an endomyocardial *** Our objective is to highlight the diagnostic evaluation and clinical implications of cardiac amyloidosis.

关键词： Cardiac amyloidosis Restrictive cardiomyopathy Transthyretin Case report

Wild type transthyretin amyloidosis,a reason not to be forgotten for heart failure of preserved ejection fraction in the elderly

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Journal of Geriatric Cardiology 2020年第12期17卷 793-796页

作者： Zhuang TIAN Chao REN Li HUO Xiao LI Yi-Ning WANG Lun HUANG Ran TIAN Shu-Yang ZHANG Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Nuclear Medicine Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Radiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Jilin Central HospitalJilinChina

amyloidosis is a multisystem disease that is characterized by deposition of fibrils in extracellular tissue,which mainly involves the kidney,heart,and autonomic nervous *** types of amyloidosis typically infiltrate the heart,including immunoglobulin light-chain(AL)and amyloid transthyretin(ATTR).ATTR is further subdivided into wild-type ATTR and variant ATTR caused by point mutations in the TTR gene.[1]Wild-type ATTR is considered as not uncommon in older patients with heart ***,a comprehensive set of consensus recommendations for the suspicion and diagnosis of ATTR was published,with particular focus on the combined application of noninvasive methods.[2]We present here a case of wild-type TTR cardiac amyloidosis(ATTRwt-CA),which was diagnosed by noninvasive modalities,and provide an overview of the recommended diagnostic approach of ***,to the best of our knowledge,this is the first Chinese case of ATTRwt-CA reported to date.

关键词： amyloidosis Cardiomyopathy Heart failure Wild-type transthyretin 99mTC-Pyrophosphate scintigraphy