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Hepatic Amyloidosis With Portal Hypertension

John P. Kapp, MD
JAMA. 1965;191(6):497-499. doi:10.1001/jama.1965.03080060071020.
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ALTHOUGH there are several reported cases of gastrointestinal hemorrhage in patients with amyloidosis, standard texts state that portal hypertension with esophageal varices rarely, if ever, occurs. This report concerns a patient with both amyloid disease and portal hypertension, and illustrates several of the problems seen in the treatment of such patients.

Report of a Case  This Negro male farmer was 46 years old at the time of his admission in 1960 for evaluation of asymptomatic hepatomegaly. Examination showed the liver edge to be at the level of the umbilicus (14 cm below the right costal margin). The liver was firm and was not tender. Moderate left lobe enlargement was noted, and the hepatic notch was easily felt. A soft systolic murmur was heard at the cardiac apex. Findings from physical examination were otherwise normal.The routine laboratory and liver-function studies are presented in Tables 1 and 2. Bone-marrow study showed


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