Emerging from the shadows: A rare case of gastrointestinal AL amyloidosis presenting as hematemesis

Abstract

We document a unique presentation of light chain (AL) amyloidosis in a 62-year-old man exhibiting as acute hematemesis and chronic abdominal discomfort. Esophagogastroduodenoscopy disclosed marked thickening of gastric and duodenal folds, gastroduodenal nodularity, and friable ulcerations. Biopsy confirmed amyloidosis. Subsequent investigations ratified a diagnosis of systemic AL amyloidosis with cardiac involvement. Initiation of the cyclophosphamide, bortezomib, and dexamethasone (CyBorD) regimen, along with tafamidis and doxycycline for cardiac pathology, led to substantial improvement of abdominal symptoms. This case highlights the variability in amyloidosis presentations and the importance of early diagnosis.

Keywords:

• AL amyloidosis
• CyBorD regimen
• esophagogastroduodenoscopy
• gastrointestinal manifestations
• hematemesis

Disclosure statement/Funding

The authors report no funding or conflicts of interest. Informed consent was obtained from the patient for the publication of this case report and accompanying images.