Presentation
We report a case of primary systemic amyloid light-chain (AL) amyloidosis, presenting initially as chronic diarrhea and weight loss. CASE PRESENTATION: A 43-year-old man with chronic diarrhea and weight loss was referred to our hospital. [ncbi.nlm.nih.gov]
Gastrointestinal
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Chronic Diarrhea
Abstract Chronic diarrhea is a frequently encountered symptom in clinical practice. The etiologies for chronic diarrhea are diverse and broad with varying clinical implications. [ncbi.nlm.nih.gov]
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Failure to Thrive
Be familiar with the many disorders that cause chronic diarrhea, both with and without failure to thrive. Know the therapies for the many causes of chronic diarrhea. [pedsinreview.aappublications.org]
Depending on the underlying cause, chronic diarrhea can lead to dehydration, malnutrition or nutritional deficiencies and failure to thrive (FTT) in young children. In severe cases it can even lead to death, mainly as a consequence of dehydration. [healthhype.com]
How long diarrhea lasts: More than two weeks Triggered by: Dairy or soy products, sometimes by egg or other proteins Symptoms appear within: two hours or more Appearance: Streaks of mucous or blood Other symptoms: Distended belly, crying, failure to thrive [verywellhealth.com]
[…] to thrive Disease courses can range from mild to severe with need of hospitalization. [amboss.com]
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Rectal Pain
Patients should see the doctor if they experience any of these symptoms: Blood or pus in the stool Black, tarry-looking stools Diarrhea that lasts longer than three days Fever of 102 degrees Fahrenheit or higher Severe abdominal or rectal pain Signs of [drweil.com]
pain You have bloody or black stools You have a fever above 102 F (39 C) In children, particularly young children, diarrhea can quickly lead to dehydration. [mayoclinic.org]
Those with ongoing diarrhea should seek medical attention if they experience: Dark urine or small amounts of urine Rapid heart rate Dry, flushed skin Headaches or light-headedness Fatigue Irritability or confusion Severe abdominal or rectal pain Blood [livescience.com]
Get to your doctor if you have a high fever (102 F or more) with diarrhea or if your stool is dark and tarry, severe abdominal or rectal pain, dehydration or if your symptoms last longer than 3 days. [globalhealingcenter.com]
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Foul Smelling Stool
Symptoms include bloating and pale or foul-smelling stools. Malabsorption can be caused by Giardia infection, lactose (a sugar found in milk) intolerance, and celiac disease (a disease caused by gluten intolerance). [aafp.org]
Sometimes arthritis, rashes, sores in the mouth, and tears in the rectum Colonoscopy CT or MRI Malabsorption disorders such as Celiac disease Tropical sprue Pancreatic insufficiency Bacterial overgrowth syndrome Light-colored, soft, bulky, and unusually foul-smelling [merckmanuals.com]
Workup
Although various strategies have been proposed for evaluation, there are still cases with undetermined origins even after extensive workup. [ncbi.nlm.nih.gov]
Workup for Suspected IBD Figure 2. Workup for suspected inflammatory bowel disease (IBD) in adults. Adapted with permission from van Rheenen PF, Van de Vijver E, Fidler V. [aafp.org]
It is unclear whether these patients had a prior workup for chronic diarrhea. 2 Secretory diarrhea was the most common etiology overall in the 2 series (21% and 45%, respectively). [mdedge.com]
Serum
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Hypertriglyceridemia
The most common side effects of sirolimus are hypertriglyceridemia, hypercholesterolemia, hypertension, rash, and well-tolerated diarrhea. [ncbi.nlm.nih.gov]
Other ECG Findings
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Ischemic Changes
The resected colon showed diffuse infiltration of EBV-positive atypical lymphocytes with ischemic change. Most atypical lymphocytes were CD3 or CD5 . [ncbi.nlm.nih.gov]
Treatment
Pharmacological treatment can also be classified into two kinds of treatment including symptomatic and causal treatment, which can be achieved through empirical therapy. [ncbi.nlm.nih.gov]
Prognosis
To date, surgery remains the only definitive therapy, with continuing dismal prognosis in metastatic disease. [ncbi.nlm.nih.gov]
The prognosis is very severe in patients 65 years old. In France, there were 1,800 deaths related to this infection in 2014. In 2013, fecal microbiote ... [centerwatch.com]
Chronic diarrhea in patients with HIV infection is an independent marker of poor prognosis [ 1–3 ]. [cid.oxfordjournals.org]
Increasing medical alertness of the natural history of the systemic amyloidosis could reduce the time to achieve the diagnosis and therapeutic decisions, also improving the prognosis. [bmcgastroenterol.biomedcentral.com]
Etiology
OBJECTIVE: To determine the clinical utility of colonic MC counts on normal biopsies in patients with chronic diarrhea of unknown etiology. [ncbi.nlm.nih.gov]
Etiologies for diarrhea in the remaining cases were infectious (11.8%), idiopathic (8.9%), celiac (7.3%), and other (10.2%). [mdedge.com]
Epidemiology
We investigated the species of Cryptosporidium to understand the epidemiology, mode of transmission, response to treatment, and prevention. [ncbi.nlm.nih.gov]
Diarrhea Treatment Diarrhea Symptoms Diarrhea Causes Diarrhea Epidemiology Diarrhea in Children Acute Diarrhea [news-medical.net]
References Ahmed F, Ansaruzzaman M, Haque E et al (2001) Epidemiology of postshigellosis persistent diarrhea in young children. [link.springer.com]
There were no relevant epidemiologic contacts. Upon physical examination, she had 8 points on the Glasgow Coma Scale and presented with tachypnea and hemodynamic instability. Her mucosae were dehydrated and her abdomen was not painful. [revistagastroenterologiamexico.org]
Pathophysiology
A useful method of categorizing chronic diarrhea to guide a diagnostic work-up is a pathophysiology-based framework. Chronic diarrhea may be categorized as malabsorptive, secretory, osmotic, and inflammatory or motility related. [ncbi.nlm.nih.gov]
Objectives After completing this article, readers should be able to: Understand the pathophysiologic mechanisms involved in chronic diarrhea. [pedsinreview.aappublications.org]
Prevention
Early medical intervention to control chronic inflammation is imperative and could prevent morbidity and mortality related to the development of secondary amyloidosis. [ncbi.nlm.nih.gov]