The 486th case: chronic diarrhea and orthostatic hypotension
10.3760/cma.j.cn112138-20200318-00260
- VernacularTitle:第486例——慢性腹泻，直立性低血压
- Author:
Qiang WANG
;
Zhangbiao LONG
;
Min QIAN
;
Jun FENG
;
Xiaoxiao GUO
;
Aiming YANG
;
Yan YOU
;
Guijun FEI
- From:
Chinese Journal of Internal Medicine
2021;60(3):284-288
- CountryChina
- Language:Chinese
-
Abstract:
A 57-year-old man was admitted to hospital with diarrhea for 10 months and dizziness for 4 months. The patient had 1-2 liters watery stool per day, without pyogenic blood or abnormality in gastroenteroscopy examination. The level of hemoglobin and albumin was generally normal, and fasting test was positive. At the same time, he was accompanied with hyperalgesia of lower limbs and orthostatic hypotension. After the discussion of multiple disciplinary teams, the patient was diagnosed with amyloidosis by sural nerve biopsy, myocardial MRI, and the assays of urine immunoelectrophoresis and serum free light chain. Light chain amyloidosis was confirmed after excluded the diagnosis of familial amyloidosis. The patient was improved after courses of chemotherapy with melphalan and dexamethasone.
