Amyloid: A Wolf in Sheep's Clothing

Amyloidosis is a complex group of diseases associated with variable presentations characterized by excessive deposition of the misfolded, abnormal, and insoluble proteins in different organs of the body. The clinical findings depend on the organs involved i.e., kidney, heart, liver, and gastrointestinal (GI) tract, etc. The goal of management in amyloidosis is to inhibit the excessive production of amyloid fibrils and control symptoms. It includes treating underlying etiologies of acquired amyloidosis such as cancers, chronic infections as well as auto-immune diseases. The GI symptoms might result in nutritional deficiencies and malabsorption. Surgical management is needed in patients with uncontrolled GI bleeding and intestinal obstruction or symptoms refractory to medical therapy. This article highlights classification, etiologies, diagnosis, and management of amyloidosis, in particular, the management of GI symptoms and malnutrition.