Renal Amyloidosis

From Anvita Health Wiki

Contents 1 Etiology 2 Epidemiology 3 Pathology 4 Clinical-manifestations 5 Laboratory 6 Management 7 More General Terms 8 Additional Terms 9 References

Etiology

• amyloid light-chain - AL amyloidosis - multiple myeloma
• serum amyloid A protein - AA amyloidosis

• tuberculosis
• injection drug use
• osteomyelitis

• beta-2 microglobulin ( hemodialysis-related amyloidosis)

Epidemiology

• 80% of patients with AL amyloidosis have renal involvement

Pathology

• amorphous, eosinophilic extracellular deposits in the glomeruli, along the tubules & in the renal blood vessels
• congo-red positive
• electron microscopy: 8-10 nm extracellular, non- branching fibrils

Clinical-manifestations

• nephrotic syndrome
• renal insufficiency
• progression to renal failure in 1-2 years is common

Laboratory

• urinalysis: albuminuria, proteinuria
• renal biopsy

Management

• see multiple myeloma
• chemotherapy directed at B-lymphocytes

• melphalan & prednisone +/- colchicine

• reduction of systemic inflammation to reduce levels of serum amyloid A protein

More General Terms

• amyloidosis
• kidney disease; renal disease

Additional Terms

• hemodialysis-related amyloidosis
• light-chain deposition disease

References

1. Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998, 2009
2. Amyloidosis and Kidney Disease [1]

renal amyloidosis