Amyloidosis-induced Lower Gastrointestinal Bleeding in a Patient with Multiple Myeloma
We reported a case of gastrointestinal amyloidosis associated with multiple myeloma (MM), presenting with an unusual abdominal condition causing right upper abdominal pain and hematochezia. An abdominal examination revealed a huge tender mass below the right costal margin. A barium enema examination demonstrated a filling defect in the transverse colon and abdominal computed tomography disclosed an inhomogeneous mass. There was no evidence of thrombocytopenia or a coagulation factor deficiency. A surgical specimen showed deposit of amyloid substance in the colon. As this case illustrates, the absence of systemic symptoms of amyloidosis and nonspecific radiological findings in gastrointestinal amyloidosis may make the diagnosis difficult. Therefore, we recommend that a diagnosis of amyloidosis-induced bleeding of the colon should be considered in patients with multiple myeloma with obscure hemorrhaging.
