Article Text

Unusual association of diseases/symptoms
A rare cause of dysphagia and gastroparesis
  1. Krishna Prakash Basavaraju1,
  2. Dina Mansour2,
  3. Stuart Barnes3,
  4. Mark W Whitehead4,
  5. Stuart A Bruce5
  1. 1
    St Thomas’ Hospital, Gastroenterology, College house, Lambeth Palace Road, London, SE1 7EH, UK
  2. 2
    Conquest Hospital, Medicine, The Ridge, St Leonards On Sea, Kent, TN37 7RD, UK
  3. 3
    Conquest Hospital, Histopathology, The Ridge, St Leonards On Sea, TN37 7RD, UK
  4. 4
    Conquest Hospital, Gastroenterology, The Ridge, St Leonards On Sea, Kent, TN37 7RD, UK
  5. 5
    Conquest Hospital, The Ridge, St Leonards On Sea, Kent, TN37 7RD, UK
  1. Krishna Prakash Basavaraju, kpbasavaraju{at}


An 82-year-old woman was admitted with severe vomiting and progressive dysphagia mainly to solids. She gave a 3-month history of increasing heartburn, vomiting, tiredness, lethargy, anorexia and 13 kg weight loss. Her past medical history was unremarkable and she was a non-smoker. Physical examination revealed evidence of significant weight loss and dehydration only. Gastroscopy revealed mild oesophagitis, tongues of Barrett oesophagus and mild antral gastritis. CT scan of the thorax and abdomen was normal. Unfortunately her condition deteriorated rapidly and she died from aspiration pneumonia. Postmortem examination revealed thickening of the muscular wall of lower oesophagus and pylorus, but without any malignancy. The histological assessment of the oesophageal as well as gastric biopsies confirmed the diagnosis of gastrointestinal amyloidosis accounting for her symptoms of dysphagia and vomiting respectively.

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  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.