Gastrointestinal manifestations of amyloidosis

We reviewed gastrointestinal manifestations in 40 patients with amyloidosis. Gastrointestinal symptoms included anorexia, macroglossia, intestinal pseudo-obstruction, and altered bowel habits. Hepatomegaly was detected in eight patients, but none had clinically significant infiltrative liver disease. Mucosal friability and erosions were common endoscopic findings. Barium enema was noncontributory in the diagnosis of amyloidosis, since colonoscopy disclosed mucosal abnormalities in three of six patients with normal radiographic findings. Rectal biopsy had the highest diagnostic yield, followed by duodenal, gastric, and colonic biopsies.