CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Endoskopie, 2007, 16, č. 1, s. 15 - 17 |
Recurrent enterorrhagia – main symptom of Waldenström
macroglobulinemia Peregrinová M.1, Frič P.1, Hranábek J.2, Mašková J.3, Zavoral M.1 1Interní klinika 1. LFUK, Přednosta: pplk. doc. MUDr. Miroslav Zavoral Ph.D. 2Oddělení hematologie, biochemie a krevní transfuze, Primář: pplk. MUDr. Miloš Bohoněk 3Radiologické oddělení, Ústřední vojenská nemocnice, Praha Primář: plk. MUDr. František Charvát Ph.D. |
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Summary: In a 70-year-old female the fatigue syndrome lasting for
several months was followed by a significant enterorrhagia.
A left-sided hemicolectomy was performed for previously
diagnosed severe diverticular disease of this part of
the colon. Histology revealed mucosal edema and irregular
arrangement of submucosal capillaries and venules.
During the next 5 months the patient experienced two
further attacks of enterorrhagia. Total colonoscopy, capsule
and double-balloon enteroscopy did not reveal any
source of bleeding. On repeated angiography colonic
angiodysplasias were described. The anemia and increased
total proteinemia indicated hematologic consultation
which resulted in the diagnosis of Waldenström macroglobulinemia.
This is the first case of the disease presenting
exclusively with colonic bleeding. Angiodysplasias
are considered a facilitating factor of the symptom.
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