Acquired factor X deficiency associated with atypical AL-amyloidosis

Intern Med. 2014;53(16):1841-5. doi: 10.2169/internalmedicine.53.2191. Epub 2014 Aug 15.

Abstract

We herein describe the case of a 77-year-old woman with acquired factor X deficiency that was likely caused by atypical amyloidosis. The patient developed severe gastrointestinal bleeding as a result of a significant decrease of factor X activity. Neither proteinuria nor diarrhea was observed as an initial manifestation. Although a bone marrow examination revealed direct fast scarlet-positive extracellular deposits, they did not exhibit red-to-green dichroism under polarized light. Immunofluorescence microscopy showed that the fibrillar proteins were positive for CD138 but negative for β2-microglobulin or amyloid A antibodies. These atypical pathological features of immunoglobulin light chain-amyloidosis in this patient might be related to its unique clinical presentation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloidosis / complications*
  • Amyloidosis / metabolism*
  • Factor X / metabolism
  • Factor X Deficiency / diagnosis*
  • Factor X Deficiency / etiology*
  • Female
  • Humans
  • Immunoglobulin Light Chains / metabolism
  • Serum Amyloid A Protein / metabolism*

Substances

  • Immunoglobulin Light Chains
  • Serum Amyloid A Protein
  • Factor X