Amyloidosis and Occult GI Bleeding
Amyloidosis and Occult GI Bleeding
Amyloidosis often eludes the clinician with its myriad clinical manifestations, likening it to the tuberculosis and syphilis of previous days. A systemic disorder, amyloidosis results from extracellular tissue deposition of beta-pleated sheets of fibrils of normal serum proteins. The 3 most common types of amyloidosis are: (1) primary amyloidosis, involving deposition of monoclonal light chains; (2) reactive or secondary amyloidosis, with deposits of serum amyloid A protein; and (3) dialysis-related amyloidosis (DRA), in which beta-2-microglobulin fibrils are deposited in various organs throughout the body. Gastrointestinal involvement occurs in 40% to 70% of all amyloid patients and is more common in those with reactive amyloidosis. DRA appears to have a lower incidence of gastrointestinal manifestations, although the precise prevalence remains unknown.
Amyloidosis often eludes the clinician with its myriad clinical manifestations, likening it to the tuberculosis and syphilis of previous days. A systemic disorder, amyloidosis results from extracellular tissue deposition of beta-pleated sheets of fibrils of normal serum proteins. The 3 most common types of amyloidosis are: (1) primary amyloidosis, involving deposition of monoclonal light chains; (2) reactive or secondary amyloidosis, with deposits of serum amyloid A protein; and (3) dialysis-related amyloidosis (DRA), in which beta-2-microglobulin fibrils are deposited in various organs throughout the body. Gastrointestinal involvement occurs in 40% to 70% of all amyloid patients and is more common in those with reactive amyloidosis. DRA appears to have a lower incidence of gastrointestinal manifestations, although the precise prevalence remains unknown.