A case of primary systemic amyloidosis with prominent hematemesis and biomechanical implications of amyloid deposition

This article reviews a case of primary systemic amyloidosis characterized by vomiting blood. The patient was treated at the Affiliated Central Hospital of Shandong First Medical University for vomiting blood. Gastroscopy pathology showed amyloid deposition and restricted expression of plasma cell light chains, with elevated free light chains in hematuria. Bone marrow biopsy confirmed primary systemic amyloidosis. Amyloid deposition significantly altered tissue biomechanical properties, including increased stiffness and reduced elasticity in affected organs such as the gastrointestinal tract and heart, contributing to organ dysfunction. The patient received a chemotherapy regimen (D-CyBorD), achieving partial remission. However, irreversible multi-organ involvement persisted, underscoring the progressive nature of amyloid-induced biomechanical and functional damage. This study highlights the interplay between amyloid pathology, biomechanical tissue changes, and clinical outcomes, emphasizing the need for early diagnosis and multidisciplinary management.