Myeloma coexisting with jejunal light chain amyloidosis

Authors

  • Aishwarya K. Marimuthu Department of Internal Medicine, Apollo Main Hospital, Greams Road, Chennai, India.
  • Purnima Ramkumar Department of Internal Medicine, Apollo Main Hospital, Greams Road, Chennai, India.
  • Mohammed S. Abdulsalam Department of Internal Medicine/Hematology, Apollo Main Hospital, Greams Road, Chennai, India.
  • Prabu Pandurangan Department of Hematology, Apollo Main Hospital, Greams Road, Chennai, India.
  • Jainudeen Khalander Abdul Jameel Department of Surgical Gastroenterology, Apollo Main Hospital, Greams Road, Chennai, India.
  • Maya Menon Department of Pathology, Apollo Main Hospital, Greams Road, Chennai, India.

DOI:

https://doi.org/10.18203/2320-6012.ijrms20204264

Keywords:

Jejunal amyloidosis, Myeloma, Hematochezia

Abstract

Amyloid Light chain (AL) amyloidosis is a rare disease, which is seen in approximately one-tenth of patients with multiple myeloma. We report a 52 years old male, who presented with complaints of anorexia and weight loss. He was diagnosed to have multiple myeloma-international staging score (ISS) Stage 3 and was started on VTD (Bortezomib, Thalidomide, and Dexamethasone) chemotherapy. Within 2 weeks of therapy, he had abdominal symptoms like abdominal pain, loose stools, vomiting and hematochezia. Imaging showed dilated proximal bowel loops with fluid filled contents and prominent vessels in rectum. Emergency surgical exploration revealed thickened proximal jejunum with blood clots in the lumen. Resection of proximal jejunum was done. Histopathological examination of resected specimen was suggestive of AL amyloidosis. Post-surgical resection of jejunum, patient had initial improvement followed by deterioration. He was discharged against medical advice as per relative’s request. Hence an index of clinical suspicion of amyloidosis must been present in all Multiple myeloma patients.

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Published

2020-09-24

How to Cite

Marimuthu, A. K., Ramkumar, P., Abdulsalam, M. S., Pandurangan, P., Jameel, J. K. A., & Menon, M. (2020). Myeloma coexisting with jejunal light chain amyloidosis. International Journal of Research in Medical Sciences, 8(10), 3738–3741. https://doi.org/10.18203/2320-6012.ijrms20204264

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Section

Case Reports