This report presents a case of renal amyloidosis
with TB as a predisposing illness.
(5,6) And although there are many different mutations possible, mutations M6994V and V726A have the most correlation to FMF with renal amyloidosis
. (5,6) Once FMF was suspected, the patient was tested for mutations M6994V and V726A.
In addition, other renal disease lesions may be caused by an HIV-active infection superimposed over viral Hepatitis B and/or C, intravenous drug use, nephrotic syndrome, drug-induced (both prescribed and recreational) interstitial nephritis, renal amyloidosis
, or crystal-induced acute renal failure caused by indinavir or acyclovir (Szczech, 2001).
(15) Our report, however, is the first, to our knowledge, to document severe progression of renal amyloidosis
following therapy for AL amyloidosis, even though monoclonal proteins were not detectable in either serum or urine.
However, renal amyloidosis
in patients with SCA is very rare in Turkey and has been reported primarily in case studies.
Conclusion was Secondary Renal Amyloidosis
(Amyloid A - positive).
To the Editor.--I read with great interest the article by Sen and Sarsik (1) regarding a proposed histopathologic classification, scoring, and grading system for renal amyloidosis
. The authors point out the importance of standardization of renal amyloid biopsy reports, which is critical to the issue of patient care and for the comparison of outcome results and therapeutic trials between different clinics.
However, in a minority of patients, called phenotype II, subclinical inflammation continues without typical attacks and culminates in AA-type renal amyloidosis
.(4) This phenotype usually affects males.
Sait Sen, MD, from Izmir, Turkey, in the second article, proposes a classification and scoring system for renal amyloidosis
that is derived from evaluation of 300 renal biopsy specimens.
It was reported that the proinflammatory cytokine TNF-a could be involved in the pathogenesis of secondary amyloidosis. The treatment with infliximab was demonstrated to be effective in the resolution of proteinuria resulting from renal amyloidosis
in a patient with rheumatoid arthritis. Metyas et al. reported a case with renal amyloidosis
secondary to FMF who was successfully treated with anti-TNF therapy.
(1-4) Histopathologic features of renal amyloidosis
have evolved over the years as more lesions have been identified and diagnosed.
is usually associated with systemic amyloidosis, whereas amyloid elsewhere may be localized or part of a systemic process.