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November 1984

Hepatic Amyloidosis: An Unusual Cause of Ascites and Portal Hypertension

Author Affiliations

From the Department of Medicine, Monash University School of Medicine,Alfred Hospital, Melbourne. Dr Itescu is now with New York University Medical Center, Bellevue Hospital, New York.

Arch Intern Med. 1984;144(11):2257-2259. doi:10.1001/archinte.1984.04400020182030

• I treated a patient who had amyloidosis with predominantly hepatic Involvement and portal hypertension. The main clinical features were hepatomegaly, gross ascites, proteinuria, and elevated alkaline phosphatase levels. Despite permanganate-sensitive AA protein being present in the biopsy specimen, none of the recognized disease entities associated With secondary amyloidosis were found. A review of the literature and the mechanism of portal hypertension In amyloidosis is given. It is suggested that elevated portal pressures may be of greater Importance in the pathogenesis of ascites in amyloidosis than has been appreciated.

(Arch Intern Med 1984;144:2257-2259)