%0 Journal Article
%T Gastric Amyloidosis Causing Nonvariceal Upper Gastrointestinal Bleeding
%A Raosaheb Rathod
%A Sridhar Sundaram
%J Archive of "ACG Case Reports Journal".
%D 2019
%R 10.14309/crj.0000000000000066
%X A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive care unit with respiratory distress, acute kidney injury, and hypercalcemia, was referred for evaluation of upper gastrointestinal (GI) bleed. The patient was on mechanical ventilation with fresh blood aspirated using the Ryles tube. On investigation, hemoglobin was 7.6 g/dL and platelets were 63,000/mm3 with international normalized ratio 1.3. Bedside upper GI endoscopy showed diffuse erythema with thickening and nodularity involving the entire stomach, without any ulceration or active bleeding (Figure (Figure1).1). Biopsies were taken from the stomach for evaluation. There was suspicion of fungal pneumonia on thorax computed tomography. Differential diagnoses included infective gastropathy and gastric involvement by amyloidosis. The patient was continued on pantoprazole, and antifungal antibiotics were added. Histopathological examination showed submucosal deposits of extracellular hyaline-like material around blood vessels, which is indicative of amyloid deposits (Figure (Figure2).2). Congo red staining revealed an apple green refringence under polarized microscopy. Despite the supportive measures, the patient's condition deteriorated, and he eventually died
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650013/