Although involvement of the small bowel by amyloid disease has been recognized for years, a malabsorption syndrome secondary to amyloid infiltration of the gastrointestinal tract seldom has been reported. This may be misleading, however, for an antemortem diagnosis formerly was difficult to make. Recent observations utilizing peroral1,2 or rectal 3,4 biopsy techniques suggest that the diagnosis of amyloidosis causing a malabsorption syndrome can now be made with relative ease.
We have reviewed the records of 103 patients with systemic amyloidosis and found evidence of intestinal malabsorption in 5 of 59 patients with primary amyloidosis and in 1 of 44 with secondary amyloidosis (including those who had associated multiple myeloma).5
The purposes of this paper are (1) to emphasize the occurrence of malabsorption syndrome secondary to amyloidosis and (2) to show the relative ease with which such a diagnosis can be established. We present the six cases encountered in