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paraproteinemias/durchfall
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A 47-year-old woman with persistent watery diarrhea, proteinuria, proximal weakness and monoclonal gammopathy.
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Amyloidosis with plasma cell dyscrasia. An overlooked caused of adult onset sensorimotor neuropathy.
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In ten previously undiagnosed patients, we have found erstwhile-"primary" nonhereditary amyloidosis as an overlooked cause of a predominately sensory, painful, and hyperesthetic distal neuropathy occurring in middle-age and older patients. These symptoms, associated with orthostatic hypotension,
Complications due to late diagnosis of celiac disease with co-existing plasma cell dyscrasia in an elderly patient.
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Celiac disease is a genetic disorder, presenting with malabsorption-related problems because of mucosal damage after ingestion of gluten. The only known effective treatment is a gluten-free diet. Early diagnosis and treatment are essential in preventing complications due to malabsorption. Here we
Primary intestinal lymphoma with paraproteinemia.
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Five cases of primary intestinal lymphoma are described. The main clinical features included abdominal pain, diarrhea, and marked weight loss, together with radiologic and some laboratory findings suggestive of malabsorption. Laparatomy perfomed in four cases revealed dilatation of the small
Plasmacytic neoplasm of the gastrointestinal tract in a patient with long-standing monoclonal gammopathy.
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We have reported the 21-year follow-up of a patient with progressive monoclonal IgG lambda gammopathy and recurrent pneumococcal infections who had diarrhea and weight loss. The serum IgG had risen from 2,850 mg/dl in 1966 to 6,120 mg/dl in 1986, but repeated evaluations had shown no evidence of
Mediterranean lymphomas with alpha heavy chain monoclonal gammopathy.
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Nine cases of Mediterranean lymphoma with alpha heavy chain disease are described. All patients were young, aged between 11 and 22 years. Neither sex predominated in the series. The clinical presentation of the disease was either gastrointestinal, with chronic diarrhea and malabsorption, or
Multi-organ affecting CMV-associated cryoglobulinemic vasculitis.
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We report on a 67-year-old female patient who was admitted to our intensive care unit with acute renal failure and severe hypoxemia. Transiently, the patient had to be treated with kidney replacement therapies and artificial ventilation. The actual illness started with general weakness, recurrent
[Bilateral optic disk edema in polyneuropathy, organomegaly, endocrinopathy, monoclonal proteins and skin changes (POEMS syndrome)].
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BACKGROUND
POEMS occurs only in about 1% of plasmocytoma cases, but in more than 50% of the rare osteosclerotic subtypes and plasma cell dyscrasias. The estimated frequency is 20 cases per year in Germany. Swelling of the optic disks is an early sign of the syndrome.
METHODS
An osteosclerotic
Pyoderma gangrenosum and ulcerative colitis in the tropics.
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Pyoderma gangrenosum is a rare inflammatory skin condition, characterized by progressive and recurrent skin ulceration. There may be rapidly enlarging, painful ulcers with undermined edges and a necrotic, hemorrhagic base. Disorders classically associated with pyoderma gangrenosum include rheumatoid
Glomerular annular-tubular immune deposits in adult hemolytic uremic syndrome.
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An 82-year-old female developed hemolytic uremic syndrome (HUS) after a prodromal illness of bloody diarrhea. No specific enteric pathogen was isolated. A renal biopsy performed 5 days after the onset of azotemia revealed typical thrombotic microangiopathy. By electron microscopy, massive
Small-intestine involvement in Waldenstrom's macroglobulinemia. Case report and review of the literature.
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A patient presented with a three-year history of diarrhea and was found to have a monoclonal gammopathy (IgM lambda) and a malabsorption syndrome with dilatation of the small bowel. Small-intestinal biopsy revealed a homogeneous eosinophilic granular material between the epithelial cells. On
[Pleural amyloidosis].
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Pleural involvement in primary (AL) amyloidosis was reported. Pulmonary involvement in patients with primary amyloidosis is not so uncommon, but the pleura is regarded as an unusual site for amyloid deposition. A woman, born in 1942, was referred for evaluation of a four-month history of edema of
Colonoscopy Leading to the Diagnosis of AL Amyloidosis in the Gastrointestinal Tract Mimicking an Acute Ulcerative Colitis Flare.
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The 2 most common types of amyloidosis are light chain (AL) and reactive (AA). AL is associated with plasma cell dyscrasias; reactive (AA) is associated with chronic inflammatory conditions. A few cases have described AL amyloidosis mimicking colitis. However, endoscopic findings leading to the
[Bullous amyloidosis].
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Although bullous amyloid lesions are very rare, the cutaneous lesions of this type can be a crucial manifestation of plasma cell dyscrasia. [Case Report] A 66-year-old man with a six-year history of multiple myeloma (IgG-lambda, lambda-type Bence Jones proteins) was admitted to the hospital because
Late-onset Familial Amyloidotic Polyneuropathy with Bence Jones Proteinuria and Cardiomyopathy.
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Familial amyloidotic polyneuropathy is a genetically determined disease characterized by deposition of an anomalous transthyretin. A high index of suspicion is needed for this multisymptomatic and lethal disease to be diagnosed. The patient was a 70-year-old male examined due to hypesthesia in the
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