Document 0723
 DOCN  M9440723
 TI    Hepatic amyloidosis in intravenous drug abusers and AIDS patients.
 DT    9404
 AU    Osick LA; Lee TP; Pedemonte MB; Jacob L; Chauhan P; Navarro C; Comer GM;
       Department of Medicine, Harlem Hospital Center, New York, NY; 10037.
 SO    J Hepatol. 1993 Aug;19(1):79-84. Unique Identifier : AIDSLINE
       MED/94132524
 AB    The clinical and pathological features of four liver biopsies and 12
       autopsies from 1981-1990 with hepatic amyloidosis were reviewed. All of
       the patients had a history of both intravenous and subcutaneous cocaine
       and heroin use with chronic suppurative skin ulcers. Five patients were
       proven to have the acquired immunodeficiency syndrome at autopsy.
       Systemic amyloidosis was diagnosed in only five out of the 16 patients
       prior to death. Hepatomegaly was present in 12 patients. The amyloid
       protein was AA in 14 and AL in one case. Definitive characterization of
       the amyloid substance was not possible in one case. There was no
       evidence of multiple myeloma or a plasma cell dyscrasia in the one
       patient with AL amyloid. The amyloid distribution in the liver was both
       parenchymal and vascular in 12 cases. Cholestasis, which appeared to
       occur preterminally, was the only histological finding that correlated
       with the patient's clinical condition. The histological pattern of
       amyloid in the liver could not predict the type of amyloid protein that
       was identified. Amyloidosis should be considered in the differential
       diagnosis of unexplained hepatomegaly in the acquired immunodeficiency
       syndrome with chronic suppurative infections.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/*PATHOLOGY  Adult
       Amyloidosis/COMPLICATIONS/*PATHOLOGY  Diagnosis, Differential  Female
       Human  Liver Diseases/COMPLICATIONS/*PATHOLOGY  Male  Middle Age
       Substance Abuse, Intravenous/COMPLICATIONS/*PATHOLOGY  JOURNAL ARTICLE

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