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Markóth C, Bidiga L, Váróczy L, File I, Balla J, Mátyus J. Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis? Ren Fail 2023; 45:2203776. [PMID: 37125610 PMCID: PMC10134948 DOI: 10.1080/0886022x.2023.2203776] [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: 05/02/2023] Open
Abstract
In light chain amyloidosis (LA), the massive glomerular and vascular amyloid deposition leading to interstitial fibrosis/tubular atrophy (IFTA) is thought to be responsible for renal failure. The amyloid deposition in the interstitium and the tubular basement membrane (TBM) has received less attention in the study of LA. We, therefore, collected clinical and laboratory data on patients diagnosed with LA in our Nephrology Department and studied amyloid deposition in the TBM. Twelve LA patients were diagnosed by renal biopsy during a seven-year period. In 4 of the 12, amyloid deposition could also be detected in the TBM. In our first case of a patient with diabetes mellitus, non-amyloid fibrils resembling 'diabetic fibrillosis' were also seen by electron microscopy. Despite the double damage, IFTA was negligible, blood vessels were unaffected, and the glomerular deposition was segmental. In the other three cases, significant (>50%) IFTA and a severely reduced estimated glomerular filtration rate were already detected at the time of diagnosis and amyloid deposition was also observed in the blood vessels. These findings indicate the importance of TBM amyloid deposition in the progression of renal disease. This may represent a late-stage presentation of the disease with a heavy LC burden.
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Affiliation(s)
- Csilla Markóth
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary
| | - László Bidiga
- Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary
- Institute of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Váróczy
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ibolya File
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - József Balla
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary
| | - János Mátyus
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary
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Prokaeva T, Akar H, Spencer B, Havasi A, Cui H, O'Hara CJ, Gursky O, Leszyk J, Steffen M, Browning S, Rosenberg A, Connors LH. Hereditary Renal Amyloidosis Associated With a Novel Apolipoprotein A-II Variant. Kidney Int Rep 2017; 2:1223-1232. [PMID: 29270531 PMCID: PMC5733886 DOI: 10.1016/j.ekir.2017.07.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 10/25/2022] Open
Affiliation(s)
- Tatiana Prokaeva
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Harun Akar
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Brian Spencer
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Andrea Havasi
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Nephrology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Haili Cui
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Carl J O'Hara
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Olga Gursky
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - John Leszyk
- Proteomics and Mass Spectrometry Facility and Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Martin Steffen
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sabrina Browning
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Allison Rosenberg
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Lawreen H Connors
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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Panizo N, Rivera F, López-Gómez JM. Decreasing incidence of AA amyloidosis in Spain. Eur J Clin Invest 2013; 43:1371. [PMID: 24020894 DOI: 10.1111/eci.12156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 08/06/2013] [Indexed: 11/30/2022]
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