Amyloidosis and Spontaneous Liver Bleeding: A Case Report and Literature Review

Liver rupture with severe liver bleeding in patients with amyloidosis is an unusual but generally difficult to deal with and potentially fatal complication in these patients. Even patients with known manifestations to the lever can present with acute lever bleeding. Here we present a case report of a 62-year-old male with systemic immunoglobulin light chain (AL) amyloidosis, known manifestations to the lever and spontaneous liver bleeding which was treated conservatively without the need of surgical intervention. The etiology, panorama of clinical manifestations of hepatic amyloidosis and the management of liver bleeding in association with this unusual disease are reviewed. 18 cases of hepatic rupture and haemorrhage in association with amyloidosis in previously published cases are summarized. The choice of management should be individualized and the patient´s hemodynamic status and extent of liver bleeding are important factors to be taken into consideration. In all patients it is crucial to exclude underlying malignancy as the reason of bleeding. The patient´s hemodynamic status and the extent of liver bleeding are the most important factors to be taken into consideration in order to establish individualized management plan. Increased awareness of severe liver bleeding from amyloidosis may achieve reduced mortality of this potentially fatal complication.