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Amyloid Deposition in Serosal Membranes-Reply

Larry A. Weinrauch, MD; John A. D'Elia, MD
Arch Intern Med. 1985;145(12):2264. doi:10.1001/archinte.1985.00360120136032.
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In Reply.  —The case report by Mallet et all is of concern, since ascites induced by peritoneal infiltration with amyloid required internal catheter drainage. Other clinically relevant serosal amyloid consequences have included pleural effusion, cardiac tamponade, and obstructive uropathy. No case of intestinal obstruction has yet appeared in the literature. Surgical interventions have included pericardial window2,3 ureteral dissection with splint insertion,2 and the peritonealjugular shunt reported by Mallet et al.1 Whereas the patient described by Mallet et al also had visceral involvement, our report was prompted by limitation of amyloid in the serosa. We agree that a longer follow-up might have led to an easier classification of the source of amyloid. Whether serosal amyloid deposition represents an organ-limited (serosa) immunocytederived amyloidosis, an immunocyte dyscrasia, or an entity related to insulin-dependent diabetes remains unclear.


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