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KMID : 0614620150660040227
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Korean Journal of Gastroenterology
2015 Volume.66 No. 4 p.227 ~ p.230
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A Case of Primary Gastric Amyloidosis with Fulminant Heart Failure
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홍성훈:Hong Seong-Hun
장영운:Chang Young-Woon/변종규:Byun Jong-Kyu/김민제:Kim Min-Je/채정민:Chae Jung-Min/박선희:Park Sun-Hee/오치혁:Oh Chi-Hyuk/박용구:Park Yong-Koo
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Abstract
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A 53-year-old woman was admitted with epigastric discomfort and weakness. Laboratory examination at admission showed mild anemia and proteinuria. Esophagogastroduodenoscopy revealed marked mucosal atrophy, diffuse nodularity and granular appearance with mucosal friability. Biopsy was performed on the antrum and body of the stomach. On the next day, the patient began to complain of severe dyspnea, and hypoxia was present on pulse oximetry. Therefore, emergency echocardiography was conducted and it showed restrictive cardiomyopathy along with thrombus in the left atrium. With time, heart failure was aggravated despite intensive management. The result of gastric biopsy revealed amyloid deposits which stained positively with Congo red. On immunohistochemistry study, kappa and lambda chain were present. In addition, kappa chain was significantly elevated in urine and serum on electrophoresis. Although the patient was finally diagnosed as having primary gastric amyloidosis with restrictive cardiomyopathy, her general condition rapidly deteriorated and died at 12th hospital day. When obscure gastric lesion is encountered, performing gastric biopsy is strongly recommended since it be primary gastric amyloidosis. Herein, we present an unusual case of primary gastric amyloidosis.
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KEYWORD
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Amyloidosis, Stomach, Heart failure
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