ABSTRACT Systemic amyloidosis involving the Gastrointestinal (GI) system often presents with vague symptoms, making early recognition challenging. This is a case of an elderly woman with known cardiac amyloid light chain (AL) amyloidosis who underwent chemotherapy using the ANDROMEDA protocol and then developed persistent reflux, epigastric pain, and constipation. Initial endoscopic assessment yielded no definitive findings. However, histologic examination with Congo red staining later revealed amyloid deposition within the gastric and ileal mucosa. Symptomatic management through supportive medical therapy was achieved without the need to modify systemic treatment. This case highlights the diagnostic difficulty of gastrointestinal amyloidosis and the importance of having a high index of suspicion for multisystem involvement when patients with amyloidosis develop nonspecific gastrointestinal complaints.
Fonbuena et al. (2026) studied this question.