Karim Muhammad

Amyloidosis is a multisystem disease characterized by the extracellular deposition of abnormal protein fibrils in various tissues and organs. It is a systemic disease mainly affecting the kidneys, liver, and spleen. In the GI tract, the duodenum is most commonly involved, followed by the stomach. We came across a relatively unusual case of jejunal amyloidosis, where the presentation was with weight loss, abdominal pain, and changes in bowel habits. Radiological findings were non-specific, such as thickening of small bowel loops and small nodular bowel wall lesions, etc. Endoscopic features were also not characteristic of any particular disease entity. Therefore, it was hard to narrow down the differential diagnosis based on endoscopy and clinic-radiological grounds. The diagnosis remained a mystery until the outcome of the final histopathology report. This case study will facilitate readers in considering this entity in the differential list if they encounter mimicking clinical and/or radiological features.

Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant protein, C-reactive protein (CRP), and an abundant circulating protein in plasma, albumin, in daily practice, this study aimed to assess the ratio of CRP and albumin for assessing the severity of acute pancreatitis. A systematic review of the literature was performed using the keywords CRP albumin ratio and acute pancreatitis in the PubMed and Cochrane databases. Studies reporting the use of the ratio of CRP and albumin in acute pancreatitis as well as the outcomes were included in this analysis. The quality of studies was assessed using the MINORS (methodological index for non-randomized studies) assessment tool. In our review, across these three studies, 956 patients with acute pancreatitis were identified and enrolled in studies that examined the relationship between the CRP/Albumin ratio and the severity of acute pancreatitis. Overall, a positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis, increased hospital length of stay, and the higher rate of mortality in these studies.