Colonic Complications from Gastrointestinal Amyloidosis

Case Report

Austin J Gastroenterol. 2014;1(5): 1023.

Colonic Complications from Gastrointestinal Amyloidosis

Reshi Kanuru, Peter P Stanich and Marty M Meyer*

Department of Gastroenterology, Hepatology & Nutrition, The Ohio State University, USA

*Corresponding author: : Marty M Meyer, Department of Gastroenterology, Hepatology,& Nutrition, Wexner Medical Center at The Ohio State University, 395 W 12th Ave, Second Floor, Columbus, OH43210, USA

Received: July 23, 2014; Accepted: September 24, 2014; Published: September 26, 2014


Amyloidosis is the deposition of protein fibrils within tissues throughout the body. The accumulation of these proteins leads to multiple organ dysfunction including heart, kidneys, and gastrointestinal tract. In the gastrointestinal system, the accumulation of amyloid can lead to nausea, vomiting, diarrhea, and even uncontrollable bleeding. We present a patient with cirrhosis secondary to hepatic amyloidosis and hematochezia due to diffuse colonic submucosal hemorrhages. Understanding the effects amyloidosis has on the gastrointestinal system will allow us to better identify affected patientsand offer earlier therapy.


Amyloidosis is a systemic disease characterized by deposition of protein fibrils in association with a plasma cell dyscrasia or an underlying chronic inflammatory disorder. The gastrointestinal tractis one of the many affected organ systems in amyloidosis. The most common segment affected is the small bowel, but the colon can also be involved. Gastrointestinal complications of amyloidosis include dysmotility, malabsorption, and bleeding. Our case highlights the severe consequences amyloidosis can cause in the gastrointestinal system, specifically those complications that arise in colon.


A 58 year old male with newly diagnosed cirrhosis secondary to hepatic amyloidosis presented with hematochezia. Prior to admission he had several months of diarrhea. On admission his hemoglobin was 8.6 g/dL and he had a platelet count of 206,000/uL. He underwent an upper endoscopy significantonly for a widely patent Schatzki’s ring. His colonoscopy showed blood throughout the colon with multiple large submucosal hemorrhages (Figures A&B) starting from the hepatic flexureand continuing into the ascending colon. Diffusely friable mucosa with oozing blood was visualized. No interventions were performed due to the diffuse nature of his lesions. Biopsies of the affected tissue showed amyloid deposits surrounding the colonic vasculatureand scattered in the muscularis mucosa (Figure C). Despite ongoing resuscitation, he had progressive liver dysfunction with ongoing hematochezia and died 10 days after colonoscopy.