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An unusual endoscopic presentation in chronic diarrhea
An unusual endoscopic presentation in chronic diarrhea - 1º Prémio (Fotografia)
Sara Santos, Verónica Borges, Guilherme Simões, Verónica Gamelas, Joana Saiote, Jorge Esteves
A 75 year-old women is referred to the Gastrenterology department for watery diarrhea that gradually worsened over 6 months and progressive weight loss (5 kg). The past medical history was remarkable for a multiple myeloma.
Laboratory studies revealed anemia (9,2 x 10g/L), hypocalcemia (7.2mg/dL). All other laboratorial workup for usual causes of chronic diarrhea were negative. The CT-scan revealed a thickening of the jejunum.
Duodenoscopy showed a fine granular appearance and mucosal friability, thickening of the valvulae conniventes.
The histology results revealed lymphatic ectasia, foamy histiocytes and deposits of hyaline material, with positive coloration for Congo Red, diagnosing Duodenal Amyloidosis.
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