Amyloidosis caused by {32 microglobulin in chronic renal failure

Authors

  • Maria José Grade Interno do Internato Complementar de Medicina Interna, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Maria José Nabais Assistente Hospitalar de Medicina Interna, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Fátima Ramos Interno do Internato Complementar de Nefrologia, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Luís Negrão Assistente Hospitalar de Neurofisiologia, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • António Cabrita Professor Auxiliar de Anatomia Patológica, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Emília Ralha Assistente Hospitalar de Nefrologia, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Pires Cabral Assistente Hospitalar de Nefrologia, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Pereira de Moura Assistente Hospitalar de Medicina Interna, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Borges Alexandrino Assistente Graduado de Medicina Interna, Serviço de Medicina II dos Hospitais da Universidade de Coimbra
  • Políbio Serra e silva Director de Serviço, Serviço de Medicina II dos Hospitais da Universidade de Coimbra

Keywords:

{32 microglobin amyloidosis, haemodialysis

Abstract

The amyloidosis, caused by {32 microglobin ( {32M) is a complication of renal substitute therapy, parti­culary with long term haemodyalisis. {32M, the prece­ eding molecule of the amyloid fibrils, accumulates in renal failure dueto its reduced excretion; the amount of the referred accumulatwn seems to depend essen­ cially on the lengh of time of dialysis and the type of membranes used

The authors have studed eleven patients subjected to regular haemodialysis, in order to discover the existence of amyloidosis caused by {32M. Resides the identification of the clinical signs of this entity, name­ly the osteoarticularsigns, of wich the most characte­ristic is the carpal tunnel syndrome. The authors sys­tematically biopsied the subcutaneous abdominal fat, made nerve conduction studies, echocardiography, bone x-rays and osteoarticular scintigraphy. The results are presented, comparing thepatients withthree or less years of haemodialysis with those who have been dialysed for more than eight years.

Concerning the results, the authors highüght thefo­ llowing: 1) The presence of CTS in 4 patients (36;4 per cent);2) Cervical spondyloarthropathy was demons­ trated in 66, 7 per cent in long term haemodialysis patients; 3) The existence of cardiac amyloidosis in 20 per cent of patients; 4) The presence of Beta 2M amyloidosis in 3 patients (27,3 per cent) in profound skin biopsies.

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References

Lcach, Valderráhano. Amiloidosis en pacientes sometidos a diáli­sis. ln: Insuficiência Renal Crónica. Dialisis y Transplante Re­nal, Norma 1990; 691-709.

Campistol J, Solé M, Gomez J, Pedret J, Revelt L. Sistemic invol­vement of dialysis-amiloidosis. Am J Nephrol 1990; 10: 389-396

Ogawa I L Saito A, Hirahayashi N, Hara K. Amyloid deposition in systemic organs in long-term hemodialysis patients. Clin Ne­phrol 1987; 28(4): 199-204.

Kleinman K, Cohurn J. Amyloid syndromes associated with he­modialysis. Kidney lnt 1989; 35: 567-575.

Serhi D, I-lutchison A, Cary N, Brown E, Cults J, Woodrow D, Gower P. Macroglossia and amyloidoma of the buttock: evi­dence of systemic involvement in dialysis amyloid. Nephron 1990; 55 312-315

Gejyo F, Homma N, Arakawa M. Long term complications of dialysis: pathogenic factors with special reference to amyloi­dosis. Kidney lnt 1993; 43(41): 78-82.

Campistol J, Molina R, ílernard D, Rodriguez R, Mirapeix E, Gomez J. Synthesis ofh2-microglobulin in lymphocyte cultu­ re: role of hemodialysis, dialysis membranes, dialysis-amyloi­dosis, and lymphokines. Am J Kidney Ois 1993; 22(5): 691-699.

Manskc C:. Dialysis-related amyloidosis. J Lab Clin Med 1994; 123(4) /458-460.

Floege J. Bartsch A. Schulzl M, Shaldon S, Koch K, Smehy L. Clearance and synthesis rates of b2- microglobulin in patients undergoing haemodialysis and in normal subjects. J Lab Clin Med 1991: 118(2): 153-165

Choi II. lleller D, l'icken M, Sidhu G, Kahn T Infarction of intestine with massive amyloid deposition in two patients on long-term haemodialysis. Gastroenterology 1989: 96: 230-234.

Chanard J, Vincent C, Claudwell V, Lavaud S, Toupance O, Wong T, Revillard J. Beta 2- microglobulin metabolism in uremic patients who are undergoing dialysis. Kidney Int 1993: 43(41) 83-87

Floege J, SchafferJ, Koch K, Shaldon S. Dialisys related amiloi­dosis: a disease of chronic retention and intlamationt Kidney Int 1992; 42(38) 78-85

Argilés A, Derancourt J, Adell J, Demaille J biochemical charac­terization of serum and urinary beta 2 microglobulin in end stage renal disease patients. Nephrol Dial Transplant 1992; 7: 1106-1110.

Spiegel D, Costante N, Haas M, Soltani K. Deposition and remo­val of cutaneous beta 2 - microglohulin. Am J Nephrol 1992;

330-335

Varga J, Idelson B, Felson D, Skinner M, Cohen A. Lack of amyloid in abdominal fat aspirares from patients undergoing long-term hemodialysis. Arch Intern Med 1987; 1'17- 1455-1457.

Felncr J, Martin R. The echocardiogram. ln: The Heart, arterics and Veins, Me Graw-Hill 1994 375-423.

Moriniére P, Marie A, Esper N, Fardellone P, Deramond N, Remond A, Seben J, Fournier A. Destructivl'. spondyloar­ thropathy with h2- microglobulin amyloid deposits in a ure­mic patient before chronic hemodialisis. Nephron 1991: 'i9: 654-657.

Ohashi K, Hara M, Kawai R, Ogura Y, Honda K, Nihei II, Mimura N. Cervical discs are most susceptibles to beta 2-mi­croglobulin amyloid deposition in the vertebral column. Kid­ney Int 1992; 41: 1646-1652.

Onishi S, Andress D, Maloney N, Cohurn J, Shcrrard D. Bera 2-microglohulin deposition in hone in chronic renal failure. Kidney Int 1991: 39 990-995

Additional Files

Published

1997-09-30

How to Cite

1.
Grade MJ, Nabais MJ, Ramos F, Negrão L, Cabrita A, Ralha E, Cabral P, de Moura P, Alexandrino B, Serra e silva P. Amyloidosis caused by {32 microglobulin in chronic renal failure. RPMI [Internet]. 1997 Sep. 30 [cited 2024 Nov. 21];4(3):163-7. Available from: https://revista.spmi.pt/index.php/rpmi/article/view/2226

Issue

Vol. 4 No. 3 (1997): Julho/ Setembro

Section

Original Articles

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