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Hellenic Archives of Pathology, Volume 19, Issues 1-3, 2005
Dialysis-related gastrointestinal amyloidosis:
Report of two cases and review of the literature
Giaslakiotis K.1, Stamatiadis D.2, Bokos J.3, Boletis J.4,
Delladetsima J.K.1
1Department of Pathology,
2Department of Nephrology,
3Department of Surgery,
4Renal Transplantation Unit, Laiko Hospital, Athens
Dialysis related amyloidosis (DRA) is a disabling complication of end stage renal failure, associated with beta-2-microglobulin amyloid (Aâ2m) deposition principally in the osteoarticular system, while complications related to gastrointestinal involvement are rare. We report two cases of gastrointestinal amyloidosis, presented with pseudo-obstruction and ileus and acute colonic perforation respectively. Patients' age was 64 and 57 years; time from initiation of hemodialysis was 19 and 20 years respectively. In one of the patients there was clinical evidence of osteoarticular involvement. Histologically, massive Aâ2m deposits were found predominantly in the muscularis propria and in a lesser extend in the wall of blood vessels. Both patients died of sepsis, despite the combined surgical and medical treatment.
Key words: Amyloidosis, beta-2-microglobulin, hemodialysis, gastrointestinal.
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