Amyloidosis presenting as a jejunal mass
Amyloidosis is a rare disease in which amyloid, an abnormal protein build up in your organs, interfering with the organ’s normal function. The abnormal protein is not normally found in the body but can be made from several different types of protein. The build-up can lead to life-threatening organ failure. The disease is either localised or generalised and commonly involves the gastrointestinal tract. This article describes the case of a 62-year-old male patient with a history of hepatitis C, diagnosed with amyloidosis that presented as a jejunal mass.
The patient’s medical history was significant for chronic hepatitis C, hypertension and type II diabetes. He had developed recurrent haematuria and a urinary tract infection with increased urinary frequency and nausea. Furthermore, his had a history of intravenous drug and smoked 25-packs of cigarettes in a year. Although, quit two years prior to his diagnosis. He was successfully treated him for hepatitis C.
Doctors presumed his symptoms were because of a urinary tract infection.
Investigations included a CT abdomen and pelvis which showed a hyperdense mass, measuring 2.3 cm in the lower pole of the left kidney. In addition, there were signs of multiple subcenter renal cysts and thickening of the mid jejunum wall, 2.0 x 2.2 cm in diameter. Given the jejunal lesion, doctors were concerned that the patient may be suffering from lymphoma. Moreover, making it a likely diagnosis because of his history of hepatitis C. He was referred to gastroenterology. For further workup doctors advised a push enteroscopy.
Further investigations included a push enteroscopy which showed multiple medium-sized submucosal masses. Histopathological analysis of the mass showed Congo red positive deposits. The findings were consistent with amyloid protein. Doctors diagnosed the patient with amyloidosis based on the findings, involving the jejunum.
The patient was closely monitored for his symptoms. 3 years later, he continues to be stable with no symptoms.
References
Unusual case of amyloidosis presenting as a jejunal mass https://casereports.bmj.com/content/14/5/e240226
