Gastrointestinal bleeding and amyloidosis.
Gastrointestinal bleeding and amyloidosis.
复制标题
胃肠道出血和淀粉样变性。
DOI：
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发表时间：
1982
期刊：
影响因子：
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通讯作者：
Rosenthal Ws
中科院分区：
文献类型：
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作者：
Levy Dj;F. Go;Rosenthal Ws
虽然消化道出血在淀粉样变性患者中是众所周知的，但当它作为疾病的初始或唯一明显表现时，它要罕见得多，并且经常导致诊断困难。这个问题是审查的背景下，病人谁经历了多次侵入性和非侵入性检查，以实现这一诊断。淀粉样变性可引起各种程度的上消化道和下消化道出血。胃肠道的弥漫性病变似乎比特异性病变更常见。我们的病人最终被发现有多个蜡样淀粉样斑块和极其脆弱的空肠粘膜内窥镜。放射学上，淀粉样变可引起粘膜皱褶弥漫性增厚，这一发现可进行广泛的鉴别诊断。动脉造影虽然不常用作淀粉样变性的诊断方法，但可显示血管管腔不规则、截断和弥漫性衰减。迄今为止，淀粉样变性的治疗一直是徒劳且困难的。讨论了几种新的治疗措施，似乎有前途。
: Although gastrointestinal bleeding is well known in patients with amyloidosis, when it occurs as the initial or sole overt manifestation of the disease it is much rarer and frequently causes diagnostic difficulty. This subject is reviewed in the context of a patient who underwent multiple invasive and noninvasive examinations to achieve this diagnosis. Both upper and lower gastrointestinal bleeding of all degrees has been shown to occur with amyloidosis. It appears that diffuse involvement of the gastrointestinal tract is much more common than a specific lesion. Our patient was ultimately found to have multiple waxy amyloid plaques and extremely friable jejunal mucosa at endoscopy. Radiographically, amyloidosis may cause diffuse thickening of the mucosal folds, a finding that carries a broad differential diagnosis. Arteriography, although not used frequently as a diagnostic modality in amyloidosis, may reveal luminal irregularities, truncation, and diffuse attenuation of the vasculature. The treatment of amyloidosis thus far has been unrewarding and difficult. Several new therapeutic measures which appear promising are discussed.