Ann Curr Gastroenterol Rep | Volume 1, Issue 1 | Case Report | Open Access

Duodenal Lymphangiectasia with Secondary Amyloidosis in a Patient with Rheumatoid Arthritis

Nalini Bansal^1*, Nishant Nagpal², Pankaj Puri² and Parveen Kumar³

¹Department of Histopathology, Fortis Escort Heart Institute, India
²Department of Gastroenterology, Fortis Escort Heart Institute, India
³Department of Radiology, Fortis Escort Heart Institute, India

^*Correspondance to: Nalini Bansal 

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Abstract

Secondary amyloidosis is known to occur in patients of rheumatoid arthritis. The clinical presentation of cases with gastrointestinal involvement is variable. We report a case of a 62-year-old female known case of rheumatoid arthritis for last 15 years on regular medication who presented with pain abdomen, diarrhea, anemia and weakness. On evaluation was found to have duodenal amyloidosis along with lymphangiectasia. The dilated lymphatics within the lamina propria were filled with aggregates of foam cells. The foam cells were Congo red negative. Association of duodenal amyloidosis with lymphangiectasia is rare with only few cases previously reported in literature. Presence of foam cells in the current case is also a strange finding not reported earlier in amyloidosis. The lymphangiectasia may develop secondary to amyloid deposition making vessel wall more permeable to plasma proteins and can explain protein losing enteropathy noted in these cases.

Keywords:

Amyloidosis; Secondary amyloidosis; Lymphangiectasia; Foam cells; Duodenum; Rheumatoid arthritis

Citation:

Bansal N, Nagpal N, Puri P, Kumar P. Duodenal Lymphangiectasia with Secondary Amyloidosis in a Patient with Rheumatoid Arthritis. Ann Curr Gastroenterol Rep. 2020; 1(1): 1001..