β2-Microglobulin Amyloidosis Presenting as Esophageal Perforation in a Hemodialysis Patient

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Abstract
A 45-year-old male with hypertensive end-stage renal disease and on maintenance hemodialysis for 13 years is reported. He presented with life-threatening hematemesis, secondary to esophageal rupture. Immunohistological staining and electron microscopy examination of the esophageal perforation showed depositions of β2-microglobulin (β2-M) amyoloid. The unique aspect presented here is the localized esophageal involvement with β2-M amyloidosis. This is the first reported patient with esophageal perforation, due to the deposition and infiltration of the lower esophagus with β2-M which predisposed to its rupture.

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