緒 言 透析アミロイドーシス(dialysis-related amyloido-sis,以下 DRA)は,一般に長期透析患者に合併し,b2microglobulin(b2-m)を構成蛋白とするアミロイドの 沈着により多彩な臓器障害をきたす疾患である.早期 には,靭帯,腱,滑膜などの関節組織に沈着し,手根 管症候群をはじめとする骨関節障害をきたし,進行期 になると消化管の血管壁や筋層などにも沈着し,食欲 不振や便秘,下痢などの消化器症状,さらには腸閉塞, 腸梗塞,腸穿孔などの重篤な消化管障害をひきおこし うる 1 . 今回,消化管アミロイドーシスによる症状は明らか ではなかったが,偶然,消化管へのアミロイド沈着が 発見された長期透析患者の 2 例を経験したので,若干 透析会誌 42 :179-183,2009 岩崎 美津子 東芝林間病院腎臓内科 〒 228-Case 1, a 68-year-old female on hemodialysis for 18 years underwent resection of anal canal tumor. Histopathological findings of the tumor showed tubular carcinoma, and deposits of b2-microglobulin amyloid were found in the small arteries of the submucosa and muscular layers. Case 2, a 75-year-old female on hemodialysis for 18 years underwent anterior cervical reconstruction. Eight days after surgery, she developed panperitonitis due to perforation of diverticulum in the sigmoid colon. The resected colon showed deposits of b2-microglobulin amyloid in the subserosal vein. Both cases were long-term hemodialysis patients, and demonstrated amyloid deposits in the colon, but there had not been any symptoms due to gastrointestinal amyloidosis. Moreover, there were differences in the distribution of amyloid deposits between the two cases.Gastrointestinal dialysis-related amyloidosis in two cases on long-term hemodialysis without gastrointestinal symptom