AA amyloidosis in the renal allograft

A report of two cases and review of the literature

Rebecca Rojas, Michelle A. Josephson, Anthony Chang, Shane M. Meehan

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

AA amyloidosis is a disorder characterized by the abnormal formation, accumulation and systemic deposition of fibrillary material that frequently involves the kidney. Recurrent AA amyloidosis in the renal allograft has been documented in patients with tuberculosis, familial Mediterranean fever, ankylosing spondylitis, chronic pyelonephritis and rheumatoid arthritis. De novo AA amyloidosis is rarely described. We report two cases of AA amyloidosis in the renal allograft. Our first case is a 47-year-old male with a history of ankylosing spondylitis who developed end-stage renal disease reportedly from tubulointerstitial nephritis from non-steroidal anti-inflammatory agent use. A biopsy was never performed. One year after transplantation, AA amyloidosis was identified in the femoral head and 8 years post-transplantation, AA amyloidosis was identified in the renal allograft. He was treated with colchicine and adalimumab and has stable renal function at 1 year-follow-up. Our second case is a 57-year-old male with a long history of intravenous drug use and hepatitis C infection who developed end-stage kidney disease due to AA amyloidosis. Our second patient's course was complicated by renal adenovirus, pulmonary aspergillosis and hepatitis C with AA amyloidosis subsequently being identified in the allograft 2.5 years post-transplantation. Renal allograft function remains stable 4-years post-transplantation. These reports describe clinical and pathologic features of two cases of AA amyloidosis presenting with proteinuria and focal involvement of the renal allograft.

Original languageEnglish (US)
Pages (from-to)146-149
Number of pages4
JournalClinical Kidney Journal
Volume5
Issue number2
DOIs
StatePublished - 2012

Fingerprint

Amyloidosis
Allografts
Kidney
Transplantation
Ankylosing Spondylitis
Hepatitis C
Chronic Kidney Failure
Pulmonary Aspergillosis
Familial Mediterranean Fever
Interstitial Nephritis
Pyelonephritis
Colchicine
Non-Steroidal Anti-Inflammatory Agents
Thigh
Proteinuria
Adenoviridae
Rheumatoid Arthritis
Tuberculosis
Biopsy
Infection

Keywords

  • AA amyloidosis
  • kidney transplant
  • post transplant

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

AA amyloidosis in the renal allograft : A report of two cases and review of the literature. / Rojas, Rebecca; Josephson, Michelle A.; Chang, Anthony; Meehan, Shane M.

In: Clinical Kidney Journal, Vol. 5, No. 2, 2012, p. 146-149.

Research output: Contribution to journalArticle

Rojas, Rebecca ; Josephson, Michelle A. ; Chang, Anthony ; Meehan, Shane M. / AA amyloidosis in the renal allograft : A report of two cases and review of the literature. In: Clinical Kidney Journal. 2012 ; Vol. 5, No. 2. pp. 146-149.
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