Amyloidosis is defined as the extracellular deposition of non-branching fibrils composed of a variety of serum-protein precursors. Secondary amyloidosis is associated with several chronic inflammatory conditions, such as rheumatologic or intestinal diseases, familial Mediterranean fever, or chronic infectious diseases, such as tuberculosis. Although the association of amyloidosis with inflammatory bowel disease is known, amyloidosis secondary to ulcerative colitis (UC) is rare. A 36-year-old male patient with a 15-year history of UC presented with nausea, vomiting, and abdominal pain. He had been treated with infliximab for 6 years. At the time of admission, he had been undergoing treatment with mesalazine and adalimumab since the preceding 5 months. Esophagogastroduodenoscopy showed mucosal erythema, edema, and erosions with geographic ulcers at the 2nd and 3rd portions of the duodenum. Duodenal amyloidosis was diagnosed using polarized light microscopy and Congo red stain. Monoclonal gammopathy was not detected in serum and urine tests, while the serum free light chain assay result was not specific. An increase in plasma cells in the bone marrow was not found. Secondary amyloidosis due to UC was suspected. The symptoms were resolved after glucocorticoid therapy.

Citations

Citations to this article as recorded by  

• Idiopathic AA amyloidosis presenting with initial abdominal pain: a case report and literature review
  Pianpian Xia, Deliang Liu, Feihong Deng, Dalian Ou, Mingyang Deng
  Frontiers in Medicine.2025;[Epub]     CrossRef
• Gastrointestinal amyloidosis in a 50‐year‐old patient with miliary tuberculosis: A case report
  Sameer Abdul Rauf, Hussain Haider Shah, Rahul Khatri, Mansoor Ul Haq, Tirth Dave, Javaria Parwez Ali, Syed Khizar Ali
  Clinical Case Reports.2024;[Epub]     CrossRef
• Therapeutic effects of biological treatments on AA amyloidosis associated with inflammatory bowel disease: a case report and literature review
  Marouf Alhalabi, Kamal Alaa Eddin, Ahmad Abbas
  European Journal of Gastroenterology & Hepatology.2023; 35(11): 1298.     CrossRef
• Rheumatoid arthritis: Extra-articular manifestations and comorbidities
  Fabiana Assunta Figus, Matteo Piga, Irene Azzolin, Rebecca McConnell, Annamaria Iagnocco
  Autoimmunity Reviews.2021; 20(4): 102776.     CrossRef
• Specific Clinical and Morphological Characteristics of Amyloidosis of the Stomach and Duodenum
  Z. V. Gioeva, L. M. Mikhaleva
  Journal of Anatomy and Histopathology.2019; 8(1): 39.     CrossRef
• Morphological and Immunohistochemical Characteristics of Experimental Mandibular Fractures Healing Process
  A. A. Matchin, A. A. Stadnikov, E. V. Nosov, S. Kh. Kiriakidi
  Journal of Anatomy and Histopathology.2019; 8(1): 44.     CrossRef
• Secondary, AA, Amyloidosis
  Riccardo Papa, Helen J. Lachmann
  Rheumatic Disease Clinics of North America.2018; 44(4): 585.     CrossRef

Crohn's disease (CD) may involve any part of the gastrointestinal tract, from the mouth to the anus. Approximately >90% of cases occur in the small bowel and colon. Upper gastrointestinal involvement, especially duodenal manifestation, is relatively rare. Therefore, adequate medical treatment for duodenal CD has not yet been established. We report a case of CD with duodenal involvement. A 46-year-old man with Crohn's ileocolitis presented to our hospital with right upper quadrant pain. An endoscopy showed a deep excavated ulcer with deformity at the duodenal bulb, and he was initially treated with azathioprine (1 mg/kg), Pentasa (3.0 g/day), and a proton pump inhibitor for 1 year. However, the deep ulcer did not heal. Therefore, infliximab infusion therapy was initiated, and the duodenal lesion completely resolved on follow-up esophagogastroduodenoscopy. We report a case of duodenal CD that completely resolved following infliximab infusion, with a review of the literature.

Citations

Citations to this article as recorded by  

• Esophageal, gastric and duodenal Crohn’s disease in the biologic era: Results from a retrospective observational nationwide study of GETECCU
  Alicia López-García, Cristina Suárez Ferrer, Carlos Maroto-Martín, Samuel Juan Fernandez-Prada, Victoria Marquina, G. Esther Rodríguez Glez, Francisco Mesonero, Alfredo J Lucendo, Pablo Flórez-Díez, María José Casanova, Natalia García-Morales, José Mirand
  Digestive and Liver Disease.2026; 58(4): 464.     CrossRef
• Duodenal Crohn’s disease: Case report and systematic review
  Muniratu Amadu, Jonathan Soldera
  World Journal of Methodology.2024;[Epub]     CrossRef
• An Obscure Presence of Gastroduodenal Involvement in a Newly Diagnosed Ileocolonic Crohn’s Disease Patient
  Clive Jude Miranda, Murad Hayatt Ali, Muddasir Ayaz, Yousef Soofi, Thomas Christopher Mahl, Hirotada Akiho
  Case Reports in Gastrointestinal Medicine.2022; 2022: 1.     CrossRef
• Challenges in Crohn's disease: Crohn's disease involving the duodenum
  Takayuki Yamamoto, Antonino Spinelli, Paulo Gustavo Kotze
  Seminars in Colon and Rectal Surgery.2020; 31(2): 100745.     CrossRef
• Isolated Severe Stricturing Duodenal Crohn Disease in a Pediatric Patient
  Keren L. Appel, Linda Wang, Dong Xi, Vrinda Bhardwaj
  JPGN Reports.2020;[Epub]     CrossRef
• Crohn’s disease of esophagus, stomach and duodenum
  Andréa Maia Pimentel, Raquel Rocha, Genoile Oliveira Santana
  World Journal of Gastrointestinal Pharmacology and Therapeutics.2019; 10(2): 35.     CrossRef
• Duodenal Crohn’s Disease
  Amy L Lightner
  Inflammatory Bowel Diseases.2018; 24(3): 546.     CrossRef
• The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease
  S. R. Brown, N. S. Fearnhead, O. D. Faiz, J. F. Abercrombie, A. G. Acheson, R. G. Arnott, S. K. Clark, S. Clifford, R. J. Davies, M. M. Davies, W. J. P. Douie, M. G. Dunlop, J. C. Epstein, M. D. Evans, B. D. George, R. J. Guy, R. Hargest, A. B. Hawthorne,
  Colorectal Disease.2018; 20(S8): 3.     CrossRef
• The endoscopic findings of the upper gastrointestinal tract in patients with Crohn’s disease
  Yoshiki Nomura, Kentaro Moriichi, Mikihiro Fujiya, Toshikatsu Okumura
  Clinical Journal of Gastroenterology.2017; 10(4): 289.     CrossRef