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Amyloidosis and the Gut

Dr. Melissa Hershman, assistant professor from the OHSU Division of Gastroenterology & Hepatology, provides an informative overview of how, and where, amyloidosis can present in the G.I. tract. She reviews patient symptoms, many of which are nonspecific and can be associated with other more common issues, delaying diagnosis. Dr. Hershman goes through  how G.I. amyloidosis is tested for, where in the G.I. tract biopsies are most commonly performed, and how the tissue is stained for diagnosis by pathology. In closing, she reviews the array of treatments available to assist patients.

Timing and co-occurrence of red-flag symptoms prior to a diagnosis of light chain (AL) amyloidosis

Dr. Anita D’Souza, associate professor of hematology and medical oncology from the Medical College of Wisconsin, discusses recent study findings regarding the timing and co-occurrence of symptoms within the three years prior to a diagnosis of light chain (AL) amyloidosis. Organized by organ system, Dr. D’Souza lists red-flag symptoms that patients may experience, typically presenting in varying combinations. Analyzing EHR records she sought to understand whether red-flag symptoms were indeed being identified, and how their occurrence would accumulate over time towards diagnosis.

Bottom line:

  • This work confirms that patients are being diagnosed within the healthcare system with multiple red-flag diagnoses before AL amyloidosis is formally diagnosed.
  • It is possible to catalog these diagnoses from electronic health records data and thus has the potential for earlier diagnosis of this complex disease.
  • This study shows the timing and combinations between these diagnoses and lays the foundation to develop clinical algorithms aimed at earlier recognition of AL amyloidosis.

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