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Amyloidosis kidney causes, clinical picture, diagnosis, treatment

• It is not a glomerulonephritis, but it is considered to be glomerulopathy.
• It presents with nephrotic syndrome, then deterioration of kidney function, eventually leading to chronic renal failure.
Causes :
1. Rheumatoid disease.
2. Suppurative lung syndrome .
3. Familial Mediterranean Fever (FMF) :
Polyserositis with recurrent abdominal pain + rebound tenderness.
- Fever (recurrent).
Nephrotic syndrome usually develops late.
4. Multiple myeloma - non Hodgkin's lymphoma.


Amyloid deposition in kidney may be consisting of immunoglobulin light chains (AL-amyloid) which occurs in cases of multiple myeloma, Waldenstrom's disease, non Hodgkin's lymphoma or in primary amyloidosis.
• Amyloid A is found in long standing inflammatory conditions e.g.suppurative lung diseases, rheumatoid arthritis and FMF.

Clinical Picture:

• C/P of the Cause + Nephrotic syndrome .
• Amyloidosis kidney also leads to renal tubular acidosis and nephrogenic diabetes insipidus.

Diagnosis:

Biopsy and staining by Congo red, this gives pink color & shows green birefringence by polarized microscope.

Treatment:

• Treatment of the cause to prevent further amyloid deposition.
• Steroids and melphalan may be helpful in primary amyloidosis.
• Colchicine in F.M.F. decreases the incidence of amyloidosis .

• Treatment of nephrotic $ and  chronic renal failure.
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Tamer Mobarak

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