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Van De Ginste L, Dendooven A, Van Dorpe J, Delanghe JR, Vanmassenhove J, Speeckaert MM. A rare presentation of kidney failure in a patient with giant cell arteritis: case report and review of literature. Acta Clin Belg 2021; 76:496-499. [PMID: 32397910 DOI: 10.1080/17843286.2020.1763671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although giant cell arteritis, also called temporal arteritis, is the most common primary vasculitis in the elderly, an association with AA amyloidosis has rarely been reported. AA amyloidosis is a disorder that results from the extracellular deposition of proteolytic cleavage products of serum amyloid A, which occurs in the setting of long-standing inflammation. We present a case of a patient with giant cell arteritis who developed a rapidly deteriorating kidney function, due to AA amyloidosis. Early recognition of this rare phenomenon is crucial as prompt treatment may be beneficial in the salvage of renal function.
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Affiliation(s)
| | - Amélie Dendooven
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | | | | | - Marijn M. Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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Radenska-Lopovok SG, Kotenko ON, Frolova NF, Zagrebneva AI, Stolyarevich ES, Volodina EV, Chervinko VI, Kryukov EV, Zubkin ML. [A rare concurrence of polymyalgia rheumatica and AA-amyloidosis]. Arkh Patol 2017; 79:53-57. [PMID: 28418359 DOI: 10.17116/patol201779253-57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Polymyalgia rheumatica (PMR) is a rare chronic inflammatory disease. It predominantly affects the elderly. The disease has a slow onset, pain and stiffness in the muscles of the shoulder and pelvic girdle, fever, weight loss, and a high acute-phase inflammatory response. The disease is concurrent with giant cell arteritis in a quarter of cases, which allows some authors to consider them as two different manifestations of the same pathological process. The kidneys are rarely involved. This disease is rarely complicated by AA amyloidosis. The authors describe a case of RPM in a patient who has developed secondary AA amyloidosis.
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Affiliation(s)
- S G Radenska-Lopovok
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Russian Medical Academy of Postgraduate Education, Ministry of Health of the Russian Federation, Moscow, Russia
| | - O N Kotenko
- Moscow City Clinical Hospital Fifty-Two, Moscow Healthcare Department, Moscow, Russia
| | - N F Frolova
- Moscow City Clinical Hospital Fifty-Two, Moscow Healthcare Department, Moscow, Russia
| | - A I Zagrebneva
- Moscow City Clinical Hospital Fifty-Two, Moscow Healthcare Department, Moscow, Russia
| | - E S Stolyarevich
- Moscow City Clinical Hospital Fifty-Two, Moscow Healthcare Department, Moscow, Russia
| | - E V Volodina
- G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow, Russia
| | - V I Chervinko
- Branch, S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation, Moscow, Russia
| | - E V Kryukov
- N.N. Burdenko Main Military Clinical Hospital, Ministry of Defense of the Russian Federation, Moscow, Russia
| | - M L Zubkin
- Moscow City Clinical Hospital Fifty-Two, Moscow Healthcare Department, Moscow, Russia; G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow, Russia; Branch, S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation, Moscow, Russia
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Sodré A, Barboza F, Pignatari J, Cortês M, Pugliesi A, Sachetto Z. AMILOIDOSE AA SECUNDÁRIA A POLIANGEÍTE MICROSCÓPICA: RELATO DE CASO E REVISÃO DE LITERATURA. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.07.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Hammelin JP, Cardon G, Reberolle M, Moulonguet F, Neugebauer Y, Raybaud G, Gnemmi V, Hachulla E. [Giant cell aortitis complicated by AA amyloidosis diagnosed with imaging techniques: Report of a case]. Rev Med Interne 2016; 38:133-136. [PMID: 27241076 DOI: 10.1016/j.revmed.2016.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 02/12/2016] [Accepted: 03/18/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AA amyloidosis is a common but severe complication of many chronic inflammatory processes of infectious, autoimmune, or neoplastic origin. It frequently leads to renal damage, often presenting as a nephrotic syndrome. Giant cell arteritis is a common inflammatory arteritis in elderly people, but rarely complicated by AA amyloidosis. CASE REPORT We report an 87-year-old female who presented with a nephrotic syndrome and a chronic inflammation, in whom the kidney biopsy showed secondary amyloidosis. Etiological investigations concluded an amyloidosis related to giant cell pan-aortitis, whereas there were no typical clinical signs for this diagnosis. Outcome was rapidly unfavourable despite the treatment. CONCLUSION In case of chronic inflammation of unknown origin in elderly patients, aortitis complicating a giant cell arteritis should be looked for with imaging techniques, as clinical diagnosis of this presentation is difficult, whereas delayed diagnosis exposes to severe or fatal issues.
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Affiliation(s)
- J-P Hammelin
- Service de néphrologie et dialyse, centre hospitalier de Douai, route de Cambrai, 59507 Douai, France.
| | - G Cardon
- Service de néphrologie et dialyse, centre hospitalier de Douai, route de Cambrai, 59507 Douai, France
| | - M Reberolle
- Service de néphrologie et dialyse, centre hospitalier de Douai, route de Cambrai, 59507 Douai, France
| | - F Moulonguet
- Service de néphrologie et dialyse, centre hospitalier de Douai, route de Cambrai, 59507 Douai, France
| | - Y Neugebauer
- Service de néphrologie et dialyse, centre hospitalier de Douai, route de Cambrai, 59507 Douai, France
| | - G Raybaud
- Service de cardiologie et explorations fonctionnelles, centre hospitalier de Douai, 59507 Douai, France
| | - V Gnemmi
- Institut de pathologie-anatomie et cytologie pathologiques, CHRU de Lille, 59000 Lille, France
| | - E Hachulla
- Service de médecine interne, hôpital Claude-Huriez, CHRU de Lille, 59000 Lille, France
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Takeshima E, Morishita Y, Ogura M, Ito C, Saito O, Takemoto F, Ando Y, Muto S, Yumura W, Kusano E. A case of diffuse endocapillary proliferative glomerulonephritis associated with polymyalgia rheumatica. CASE REPORTS IN NEPHROLOGY AND UROLOGY 2012; 2:158-64. [PMID: 23326256 PMCID: PMC3542932 DOI: 10.1159/000345280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 70-year-old man complained of muscle pain in his neck, shoulders and pelvic girdle. Proteinuria and hematuria subsequently developed. Blood analysis showed increased acute phase reactants. The histology of renal biopsy showed diffuse endocapillary proliferative glomerulonephritis. There were no signs of autoimmune diseases, malignancies and bacterial or viral infections. His extrarenal symptoms and the results of blood analysis fulfilled three different criteria of polymyalgia rheumatica (PMR). Therefore, diffuse endocapillary proliferative glomerulonephritis associated with PMR was diagnosed. After low-dose prednisolone (10 mg/day) treatment, the muscle pain disappeared, acute phase reactants decreased and hematuria and proteinuria improved. The renal complication of PMR is rare but important to be considered early in the right clinical context.
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Affiliation(s)
- Eri Takeshima
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-shi, Japan
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LEGAULT KIMBERLY, SHROFF ANJALI, CROWTHER MARK, KHALIDI NADER. Amyloidosis and Giant Cell Arteritis/Polymyalgia Rheumatica. J Rheumatol 2012; 39:878-80. [DOI: 10.3899/jrheum.111013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Javaid MM, Kamalanathan M, Kon SP. RAPID DEVELOPMENT OF RENAL FAILURE SECONDARY TO AA-TYPE AMYLOIDOSIS IN A PATIENT WITH POLYMYALGIA RHEUMATICA. J Ren Care 2010; 36:199-202. [DOI: 10.1111/j.1755-6686.2010.00200.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bhat A, Selmi C, Naguwa SM, Cheema GS, Gershwin ME. Currents concepts on the immunopathology of amyloidosis. Clin Rev Allergy Immunol 2010; 38:97-106. [PMID: 19626465 DOI: 10.1007/s12016-009-8163-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Amyloidosis is defined as the extracellular accumulation at systemic or organ-specific level of insoluble low molecular weight protein fibrils manifesting a beta pleated sheet configuration and a characteristic staining pattern. Several different types of proteins may lead to this phenomenon, and amyloidosis is defined by the biochemical nature of the protein in the deposits and further classified according to whether the deposits are localized or systemic, acquired or inherited, and by the resulting clinical phenotype. Amyloidosis includes subtypes such as light chain, associated with serum amyloid A protein, heritable and familial forms, dialysis-related disease, and organ-specific conditions. The pathogenesis and clinical features of these clinical and pathological entities will be critically discussed in this review article.
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Affiliation(s)
- Anupama Bhat
- Division of Rheumatology, Allergy and Clinical Immunology, Genome and Biomedical Sciences Facility, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA 95616, USA
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Ubara Y, Tagami T, Suwabe T, Sogawa Y, Hoshino J, Higa Y, Nomura K, Sawa N, Katori H, Takemoto F, Hara S, Watanabe T, Ohashi K, Takaichi K. Systemic AA-amyloidosis related to MPO-ANCA microscopic polyangiitis: a case report. Amyloid 2006; 13:178-83. [PMID: 17062385 DOI: 10.1080/13506120600876815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report autopsy findings in an 83-year-old woman with myeloperoxidase-type anti-neutrophil cytoplasmic antibody (MPO-ANCA)-positive microscopic polyangiitis and systemic AA amyloidosis. With a diagnosis of MPO-ANCA-related microscopic polyangiitis, the patient was treated with corticosteroids, but she died of intractable enteritis. Autopsy showed inactive vasculitis affecting small arteries in kidney, lung, intestinal tract, and skeletal muscle. Gastrointestinal viscera were thickened, and AA-amyloid was demonstrated in arterioles and surrounding tissues. Amyloidosis also involved heart, kidney, gallbladder, pancreas, salivary gland, and subcutis. ANCA-positive microscopic polyangiitis appears to have been the likely cause of this patient's AA-amyloidosis.
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Schlegel A. 25-year follow-up of a case of giant cell aortitis. Am J Med 2004; 117:625. [PMID: 15465520 DOI: 10.1016/j.amjmed.2004.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Beydoun SR, Rison RA, Commins D. Secondary amyloidosis as a life-ending event in multifocal motor neuropathy. Muscle Nerve 2001; 24:1396-402. [PMID: 11562923 DOI: 10.1002/mus.1162] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Multifocal motor neuropathy (MMN) is a disorder of peripheral nerve often associated with a high monosialoganglioside (GM1) antibody and multifocal conduction block. It has a chronic, indolent course with involvement of predominantly peripheral motor nerves, usually in an asymmetric fashion. There have been few reported cases of progression to frank quadriplegia. Secondary amyloidosis refers to the deposition of amyloid in various tissues due to an underlying chronic inflammatory state. We report the first case, to our knowledge, of a patient with MMN associated with high titer of GM1 antibody who developed acute paraplegia with both cranial nerve and worsening sensory involvement associated with multiorgan compromise due to a secondary amyloidosis involving the myocardium.
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Affiliation(s)
- S R Beydoun
- Keck University of Southern California School of Medicine, Department of Neurology, 1450 San Pablo Street, Suite 1900, Los Angeles, California 90033, USA.
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Altiparmak MR, Tabak F, Pamuk ON, Pamuk GE, Mert A, Aktuğlu Y. Giant cell arteritis and secondary amyloidosis: the natural history. Scand J Rheumatol 2001; 30:114-6. [PMID: 11324788 DOI: 10.1080/03009740151095448] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Giant cell (temporal) arteritis (GCA) may be a cause of fever of unknown origin (FUO) in elderly patients. The development of secondary (reactive) amyloidosis is an unusual complication of the disease. We describe a 65-year-old male patient who was hospitalized in our hospital with FUO and was diagnosed as having GCA 5 years later. At that time, he also had a nephrotic syndrome and secondary amyloidosis (AA-type). He died due to end-stage renal failure. The probable explanation for the development of this rare complication might be the late diagnosis of this chronic inflammatory disease, which was left untreated for a long period of time.
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Affiliation(s)
- M R Altiparmak
- Department of Nephrology, Cerrahpasa Medical Faculty, University of Istanbul, Turkey
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