Gastrointestinal amyloidosis in a patient with systemic sclerosis

There were more than 90% of systemic sclerosis (SSc) patients developing gastrointestinal tract involvement with affecting esophagus mostly. However, a typical gastrointestinal manifestation may be not the only result of SSc. We described a 70-year-old female with SSc presented poor appetite, intermittent heartburn sensation, nausea, frequent sensation of abdominal fullness, and intermittent dull pain for 2 months. The esophagogastroduodenoscopy showed gastrointestinal as gastroesophageal reflux disease. The biopsy revealed amorphous material deposited in the vascular walls and apple-green birefringence in a polarization examination with Congo red staining which proved amyloidosis. The SSc patient with gastrointestinal involvement suggests to receive esophagogastroduodenoscopy, and a biopsy may be helpful to these patients to examine the possibility of secondary amyloidosis. These patients need more aggressively disease activity control.