Intest Res.  2010 Dec;8(2):195-199. 10.5217/ir.2010.8.2.195.

Pseudo-Obstruction of Jejunum due to AA Amyloidosis Associated with Latent Syphilis

• Hwangbo Y
• Kim HJ
• Lee JY
• Jang JY
• Dong SH
• Kim BH
• Chang YW
• Chang R

• KMID: 2284940
• DOI: http://doi.org/10.5217/ir.2010.8.2.195

Abstract

Amyloidosis uncommonly presents with intestinal pseudo-obstruction. According to previous reports, patients with primary AL amyloidosis presented with a chronic process with symtom duration of more than 1 year, but patients with secondary AA amyloidosis presented as an acute illness, usually less than 10 weeks. Localized gastrointestinal amyloidosis limited to the jejunum, without involvement of stomach, duodenum, colon, or rectum, is very rare. Imaging studies in small intestinal amyloidosis generally show a symmetrical uniform appearance. AA amyloidosis with acute-phase reactant serum amyloid A protein is associated with inflammatory, infectious or neoplastic disorders. To our knowledge, no case of amyloidosis associated with latent syphilis has been reported to date. We present a case of a 56-year-old man who presented with clinical and radiographic features of a small bowel obstruction and obscure gastrointestinal bleeding. Investigations including laparoscopy and other laboratory dataled to a diagnosis of pseudo-obstruction of the jejunum due to AA amyloidosis associated with latent syphilis. After appropriate treatment for latent syphilis, abdominal symptoms had been disappeared, but jejunal dilatation was still present two years later.

Keyword

Amyloidosis; Syphilis; Intestinal Pseudo-Obstruction; Jejunum

MeSH Terms

Amyloidosis
Colon
Dilatation
Duodenum
Hemorrhage
Humans
Intestinal Pseudo-Obstruction
Jejunum
Laparoscopy
Middle Aged
Rectum
Serum Amyloid A Protein
Stomach
Syphilis
Syphilis, Latent
Serum Amyloid A Protein