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Amyloid arthropathy in patients undergoing periodical haemodialysis for chronic renal failure: a new complication.
Muñoz Gómez, José; Bergadá-Barado, E.; Gómez-Pérez, R.; Llopart-Buisán, E.; Subías-Sobrevía, R.; Rotés Querol, J. (Jaume), 1921-2008; Solé Arqués, Manuel
Universitat de Barcelona
Seven patients (five male and two female) with chronic renal failure (CRF) treated by periodical haemodialysis presented with swelling and effusion of more than three months' duration in knees (four bilateral), shoulders (two, one of them bilateral), elbow (one), and ankle (one). Four had a carpal tunnel syndrome both clinically and electromyographically (three bilateral). All patients had hyperparathyroidism secondary to their CRF, which was not due to amyloidosis in any of them. The dialysis duration period varied from five to 14 years, with an average of 8.6 years. Amyloid deposits (Congo red positive areas with green birefringence under polarising microscopy) were shown in six of the seven synovial biopsy specimens of the knee, in five of the sediments of the synovial fluids, and in specimens removed during carpal tunnel syndrome surgery. No amyloid was found in the biopsy specimen of abdominal fat of six of the patients. The finding of amyloid only in the synovial membrane and fluid, and carpal tunnel, its absence in abdominal fat, and the lack of other manifestations of generalised amyloidosis (cardiomyopathy, malabsorption syndrome, macroglossia, etc.) and of Bence Jones myeloma (protein immunoelectrophoresis normal) raises the possibility that this is a form of amyloidosis which is peculiar to CRF treated by periodical haemodialysis.
2012-03-07
Artropatia
Insuficiència renal crònica
Hemodiàlisi
Estudi de casos
Complicacions (Medicina)
Arthropathy
Chronic renal failure
Hemodialysis
Case studies
Complications (Medicine)
(c) BMJ Publishing Group Ltd, 1985
Article
BMJ Group
         

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