{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:08:22Z","timestamp":1770275302604,"version":"3.49.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,29]]},"abstract":"<jats:p>Dysphagia is an uncommon presentation of systemic immunoglobulin light-chain (AL) amyloidosis with multiple myeloma (MM). Gastrointestinal (GI) involvement usually manifests with altered motility, malabsorption or bleeding. Furthermore, patients identified with GI amyloidosis, without previous diagnosis of a plasma cell disorder, are extremely rare. We report an elderly woman who presented with acute on chronic cardiac dysfunction, sick sinus syndrome and acute renal failure. While admitted, she developed intermittent dysphagia to both solids and liquids. Oesophagogastroduodenoscopy showed ulcerations of oesophagus and duodenum. Biopsies revealed focal amyloid deposition, stained with Congo red. Renal biopsy revealed amyloid deposition in renal arterioles. She underwent a bone marrow biopsy confirming MM, represented by more than 15% plasma cell population. She was started on treatment for heart failure, induction chemotherapy for MM and percutaneous gastrostomy tube for feeding. However, she continued to deteriorate, eventually opting for hospice, and ultimately died 2\u2009days after discharge from hospital.<\/jats:p>","DOI":"10.1136\/bcr-2018-226331","type":"journal-article","created":{"date-parts":[[2018,10,21]],"date-time":"2018-10-21T13:04:26Z","timestamp":1540127066000},"page":"bcr-2018-226331","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Dysphagia unveiling systemic immunoglobulin light-chain amyloidosis with multiple myeloma"],"prefix":"10.1136","volume":"2018","author":[{"given":"Juan","family":"Gonzalez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-1838","authenticated-orcid":false,"given":"Ahsan","family":"Wahab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavitha","family":"Kesari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,10,21]]},"reference":[{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01669.x"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.2","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1002\/ajh.24433","article-title":"Immunoglobulin light chain amyloidosis: 2016 update on diagnosis, prognosis, and treatment","volume":"91","author":"Gertz","year":"2016","journal-title":"Am J Hematol"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.3","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/jgh.13996","article-title":"Systemic amyloidosis with gastrointestinal involvement: Diagnosis from endoscopic and histological views","volume":"33","author":"Iida","year":"2018","journal-title":"J Gastroenterol Hepatol"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.4","first-page":"e1228","article-title":"Gastrointestinal amyloidosis: Review of the literature","volume":"9","author":"Rowe","year":"2017","journal-title":"Cureus"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.5","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1182\/blood.V79.7.1817.1817","article-title":"Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989","volume":"79","author":"Kyle","year":"1992","journal-title":"Blood"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.6","doi-asserted-by":"crossref","first-page":"496","DOI":"10.3904\/kjim.2015.30.4.496","article-title":"Clinical features and outcomes of systemic amyloidosis with gastrointestinal involvement: a single-center experience","volume":"30","author":"Lim","year":"2015","journal-title":"Korean J Intern Med"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/320120","article-title":"Upper gastrointestinal bleeding from gastric amyloidosis in a patient with smoldering multiple myeloma","volume":"2015","author":"Gjeorgjievski","year":"2015","journal-title":"Case Rep Gastrointest Med"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11894-018-0616-y","article-title":"Small bowel amyloidosis","volume":"20","author":"Bansal","year":"2018","journal-title":"Curr Gastroenterol Rep"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.9","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v3.i8.157"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.10","doi-asserted-by":"crossref","first-page":"e2018022","DOI":"10.4084\/mjhid.2018.022","article-title":"Light chain Amyloidosis","volume":"10","author":"Milani","year":"2018","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.11","doi-asserted-by":"crossref","unstructured":"Menke DM , Kyle RA , Fleming CR , et al . Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis. 1993;68:763\u20137.","DOI":"10.1016\/S0025-6196(12)60634-X"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2009.04.024"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.13","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-010-0108-7"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.14","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s13000-015-0407-9","article-title":"Primary systemic amyloidosis initially presenting with digestive symptoms: a case report and review of the literature","volume":"10","author":"Lin","year":"2015","journal-title":"Diagn Pathol"},{"key":"2025042706364438000_2018.oct19_1.bcr-2018-226331.15","doi-asserted-by":"crossref","unstructured":"Rajkumar SV , Gertz MA . 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