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Updated: Nov 7, 2025

Performing and Processing FNA of Anterior Fat Pad for Amyloid
Published on: October 30, 2010
Secondary Amyloidosis Presenting as Ischemic Proctitis
Saad Hashmi1, Assad Munis2, Ryan T Hoff2
1Advocate Lutheran General Hospital, Department of Internal Medicine, Park Ridge, IL, USA.
This study details a rare case of AA amyloidosis presenting with gastrointestinal symptoms. Diagnosis required specialized staining of biopsies, highlighting the importance of considering amyloidosis in unexplained weight loss and bleeding.
Area of Science:
- Gastroenterology
- Nephrology
- Genetics
Background:
- Gastrointestinal amyloidosis is an uncommon condition.
- AA amyloidosis is associated with chronic inflammation.
- Familial Mediterranean Fever (MEFV) gene variants can influence amyloidosis risk.
Observation:
- A 49-year-old man with obesity and gout presented with abdominal pain, rectal bleeding, and significant weight loss.
- Imaging revealed rectal wall thickening, and colonoscopy showed proctitis with ulcerations.
- Renal insufficiency and low-voltage ECG complexes prompted consideration of amyloidosis.
Findings:
- Rectal, renal, and gallbladder biopsies confirmed amyloid deposition, establishing a diagnosis of AA amyloidosis.
- The patient had a heterozygous complex variant in the MEFV gene, potentially linked to gout and obesity, contributing to AA amyloidosis.
- Amyloid deposition in the gallbladder and rectum is exceptionally rare.
Implications:
- This case underscores the need for heightened awareness of atypical amyloidosis presentations.
- Diagnostic protocols should include specific staining for amyloid in relevant biopsies.
- Early diagnosis of gastrointestinal amyloidosis enables targeted therapeutic strategies.
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