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Hepatic Amyloidosis at a Tertiary Liver Care Center in India: A Case Series
 
Sachin Chaudhari1, Archana Rastogi1, Kanika Taneja1, Shalini Thapar3, Chhagan Bihari1, Rakhi Maiwall2
1Department of Pathology, 2Department of Hepatology, 3Deparatment of Radiodiagnosis, Institute of Liver and Biliary Sciences, New Delhi.


Corresponding Author
:
Dr Archana Rastogi
Email: drarchanarastogi@gmail.com


Abstract

Background: Liver is involved in 10%  cases of amyloidosis and can be involved in primary (AL) or secondary amyloidosis. These patients have various clinical features and carry poor prognosis.
Aim: To study the clinicopathologial and histomorphological features of Hepatic amyloidosis.
Material and Methods: Total 26 Patients with biopsy diagnosis of hepatic amyloidosis were retrospectively analyzed. Relevant clinical information and laboratory data was obtained. All the liver biopsies were reviewed. Special stains immunohistochemistry was performed. 
Results: Age was ranging from 15-80 years with Male to female ratio of 10:3. Eighteen had abdominal distention. Hepatic venous pressure gradient measurement was done in 12 patients with readings from 5-28 mm of Hg. Three showed Grade I esophageal varices.  Three were Hepatitis B surface antigen positive.  Most common pattern of amyloid deposition was only sinusoidal and sinusoidal with portal stroma (n=9 in each group). 
Conclusion: Increased level of Serum alkaline phosphatase was observed which is matching with previous studies. The most common pattern in AA and non AA cases was sinusoidal pattern either as isolated or associated with some other form. Increased liver stiffness on fibroscan is due to infiltration by amyloid material. To conclude, we are reporting the first large case series of Hepatic amyloidosis from a tertiary liver care center in India. We studied various parameters. Further larger studies with long term follow up will help in better understanding of the disease.