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A rare cause of lower GI bleeding.
Mohammad Waleed1, A Mohamed Ali, Othman Saraj
1Department of Gastroenterology, Scarborough General Hospital, North Yorkshire, UK. waleed1280@yahoo.com
BMJ Case Reports
|September 11, 2012
Summary
A rare case of lower gastrointestinal bleeding caused by amyloidosis, a complication of multiple myeloma, is presented. This finding highlights the importance of considering myeloma in patients with unexplained GI bleeding.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- Multiple myeloma is a plasma cell malignancy that can lead to amyloidosis.
- Amyloidosis is a condition where abnormal proteins build up in organs, potentially causing dysfunction.
- Gastrointestinal involvement in amyloidosis, though rare, can manifest as bleeding.
Observation:
- A 79-year-old female presented with a four-week history of bloody diarrhea.
- Flexible sigmoidoscopy revealed mild inflammation of the sigmoid colon mucosa.
- Abdominal CT scan identified lytic lesions in the vertebral bodies.
Findings:
- Diagnostic tests, including 24-hour urine protein analysis and serum electrophoresis, indicated multiple myeloma.
- A bone marrow biopsy confirmed the diagnosis of plasma cell myeloma.
- The patient's lower gastrointestinal bleeding was attributed to amyloidosis secondary to multiple myeloma.
Implications:
- This case underscores the significance of investigating multiple myeloma in patients presenting with lower gastrointestinal hemorrhage.
- Recognizing GI amyloidosis as a complication of multiple myeloma is crucial for accurate diagnosis and management.
- Early identification and treatment of multiple myeloma can potentially prevent or mitigate gastrointestinal complications.