ACASE OF SECONDARY AMYL OIDOSIS ACCOMPANYING ILEAL ULCERS

Abstract

A 54 year-old female with a history of rheumatoid arthritis for more than fire yearswas admitted due to progressing watery diarrhea and vomiting. Endoscopic examinationfor upper and lower gastrointestinal tract failed to show any specific findings foramylaidcsis, but revealed wide range of non-specific inflammatory changes such as redness, erosions and irregular shallow ulcers. Punch hiapsy specimens taken from both upperand lower gastrointestinal tract showed deposition of amyloid, which was confirmed byCongo-red stainings and immunostainings for amyioid A protein. Thus the patient wasdiagnosed as amyloidosis secondary to rheumatoid arthritis. She had been well for severalmonths by TPN, and died by heart fallure. Although amyloidosis is commonly accepted asasystemic disease, a few cases have been reported so far with some Iesions throughout thegastrointestinal tract. It is suggested that frequent endoscapic exarnination may be helpfulfor not only making accurate diagnosis but also understanding rapid changes in intestinallesions of patients with amyloidosis.