RT Journal Article SR Electronic T1 Symptomatic involvement of the stomach and duodenum as initial presentation of AL amyloidosis JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr-2018-227550 DO 10.1136/bcr-2018-227550 VO 12 IS 1 A1 Faisal Inayat A1 Asad Ur Rahman A1 Effa Zahid A1 Nouman Safdar Ali A1 Roger Charles YR 2019 UL http://casereports.bmj.com/content/12/1/bcr-2018-227550.abstract AB Primary systemic or amyloid light chain (AL) amyloidosis is a multisystem disorder with myriad presentations. Although it can involve the upper gastrointestinal tract in 8% of cases, symptomatic involvement is exceedingly rare. We chronicle here a case of postprandial epigastric pain associated with AL amyloidosis involving the stomach and duodenum. Pathological examination of endoscopic biopsy using Congo red staining confirmed the diagnosis. In order to establish the underlying aetiology of AL amyloidosis, the patient underwent extensive workup. Eventually, she was diagnosed with multiple myeloma based on the standard set of investigations. This paper underscores the importance of clinical suspicion of amyloidosis in patients presenting with non-specific gastrointestinal symptoms and highlights the role of endoscopic biopsy to confirm the amyloid deposition. Since gastrointestinal amyloidosis is a disease with a poor prognosis, early diagnosis and treatment are particularly warranted.