Spontaneous rupture of the spleen and liver in amyloidosis A Case report and review of the literature

Okazaki, Kazuichi; Moriyasu, Fuminori; Shiomura, Tadahiko; Yamamoto, T.; Suzaki, Takeshi; Kanematsu, Yuzo; Akasaka, Seiji; Kobashi, Yoichiro

doi:10.1007/bf02774637

Cited by 30 publications

(13 citation statements)

References 21 publications

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“…1,9 There are also reports describing SSR in patients with amyloidosis. 10,11 Some procedures, such as electroconvulsive therapy, implantation of automatic defibrillators, shock wave lithotripsy, colonoscopy, and transesophageal echocardiography, are also associated with SSR. 1 In most of these conditions or diseases, the spleen is directly affected and the predisposing factors for rupture are increased size, inflammation, and changes in structural integrity.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Rupture of the Liver and Spleen in a Patient on Warfarin Therapy: Report of a Case

Kapan

Karabıçak

et al. 2005

Surg Today

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Section: Discussionmentioning

confidence: 99%

Simultaneous Rupture of the Liver and Spleen in a Patient on Warfarin Therapy: Report of a Case

Kapan

Karabıçak

et al. 2005

Surg Today

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“…In a review of the literature, we have been able to identify 17 cases of splenic rupture associated with amyloidosis reported since 1948 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Although this number does not define the actual incidence of spontaneous rupture of the spleen in amyloidosis, it suggests the splenic rupture is a rare complication in this disease.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of the spleen in AL amyloidosis

et al. 2003

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The frequency of splenic involvement in AL amyloidosis is not precisely known. However, splenomegaly has been reported in 4-13% of patients. We report four cases of spontaneous splenic rupture in patients with AL amyloidosis. Splenic rupture was the initial manifestation of the disease in one of these patients. The other three experienced splenic rupture during or after high-dose intravenous melphalan with autologous peripheral blood stem cell transplantation (HDM/SCT): one during stem cell mobilization with G-CSF prior to HDM/SCT and two after hematopoietic recovery following treatment. Two of the four patients had Factor X deficiency, the most common coagulation abnormality associated with AL amyloidosis. All four patients underwent splenectomy without significant postoperative complications. Splenic rupture in AL amyloidosis as a complication of aggressive treatment with HDM/SCT has not been reported previously. Am.

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“…It is generally thought to be caused by rapid expansion of the splenic capsule, which has become rigid because of amyloid deposits and then ruptures [8,37,481. Fragility of the vascular red pulp from amyloid infiltration of the blood vessel walls [2,24,32,35,371, and coagulation abnormalities including factor X deficiency and prothrombin time prolongation 126,501, may also be contributory factors.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation as rescue treatment in a patient with primary AL kappa amyloidosis

Nowak¹,

Westermark

Wernerson

et al. 2000

Transplant Int

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Although involvement of the liver is common in systemic amyloidosis, clinical manifestations of hepatic dysfunction and liver biochemical abnormalities are often absent or only mild. Here we report on a patient with primary amyloidosis and rapid development of liver failure, who was successfully treated by liver transplantation. The patient is a 61-year-old Swedish man who was admitted to the local hospital for spontaneous rupture of the spleen. Before admission, he had suffered from diffuse upper abdominal discomfort, diminished appetite, and had lost 15 kg in 6 months.Shortly after splenectomy, he developed cholestatic liver failure with moderate hepatomegaly, jaundice, ascites and hyponatremia. Over a period of 3 weeks his liver failure progressed, renal function deteriorated rapidly, and he developed encephalopathy. Liver transplantation was performed on the 35th day after splenic rupture. Histological examination revealed extensive deposits of arnyloid in the spleen and liver. N-terminal amino acid sequence analysis of the amyloid protein, purified from the patient's native liver, revealed an AL protein of kappa I-type origin. The postoperative course was uncomplicated, apart from one episode of sepsis and one course of treatment for acute rejection. He was discharged from hospital with normal liver function and good kidney function. One year after surgery, he was in good condition, with normal liver function. However, a liver biopsy taken at the same time showed de novo amyloid deposits in the grafted liver. We conclude that liver transplantation may be indicated as a life-saving procedure in rapidly progressing hepatic amyloidosis with cholestatic jaundice, although the underlying disease has not changed.

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Spontaneous rupture of the spleen and liver in amyloidosis A Case report and review of the literature

Cited by 30 publications

References 21 publications

Simultaneous Rupture of the Liver and Spleen in a Patient on Warfarin Therapy: Report of a Case

Simultaneous Rupture of the Liver and Spleen in a Patient on Warfarin Therapy: Report of a Case

Spontaneous rupture of the spleen in AL amyloidosis

Liver transplantation as rescue treatment in a patient with primary AL kappa amyloidosis

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