[Abdominal pain: It still can be a zebra].
Koni Alessandro Strotz-Giampà1, Katharina Seoko Brändle1, Veronika Ballova2
1Departement Innere Medizin, Kantonsspital Baden, Baden, Schweiz.
Praxis
|December 11, 2025
Summary
A patient with acute abdominal pain was diagnosed with multiple myeloma and AL amyloidosis. This condition led to nephrotic syndrome, causing splanchnic vein thrombosis, specifically in the superior mesenteric vein.
Area of Science:
- Internal Medicine
- Hematology
- Nephrology
Background:
- A 51-year-old patient presented with acute lower abdominal pain.
- CT imaging identified superior mesenteric vein thrombosis.
- The patient exhibited nephrotic proteinuria and elevated lambda light chains.
Purpose of the Study:
- To investigate the underlying cause of splanchnic vein thrombosis.
- To establish a diagnosis for the patient's complex clinical presentation.
Main Methods:
- Computed Tomography (CT) imaging for vascular assessment.
- Laboratory tests including urinalysis for proteinuria and serum free light chains.
- Echocardiography to evaluate cardiac structure and function.
- Bone marrow biopsy for hematological analysis.
Main Results:
- CT confirmed superior mesenteric vein thrombosis.
- Echocardiography revealed findings consistent with cardiac amyloidosis.
- Bone marrow biopsy established a diagnosis of multiple myeloma.
- The patient was diagnosed with AL amyloidosis and nephrotic syndrome.
Conclusions:
- Multiple myeloma with AL amyloidosis and resultant nephrotic syndrome was identified as the cause of splanchnic vein thrombosis.
- This case highlights the systemic manifestations of multiple myeloma and its association with venous thromboembolism.
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