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Beta-2-Microglobulin-Derived Amyloidosis: Onset, Distribution and Clinical Features in 13 Hemodialysed Patients

 

作者: G. Stein,   A. Schneider,   K. Thoss,   E. Ritz,   R.P. Linke,   K. Schaefer,   H. Sperschneider,   K. Abendroth,   R. Fünfstück,  

 

期刊: Nephron  (Karger Available online 1992)
卷期: Volume 60, issue 3  

页码: 274-280

 

ISSN:1660-8151

 

年代: 1992

 

DOI:10.1159/000186765

 

出版商: S. Karger AG

 

关键词: Hemodialysis;Amyloidosis;β2-Microglobulin;Arthralgia;Spondylarthropathy

 

数据来源: Karger

 

摘要:

Postmortem examinations were carried out in 13 patients (6 males, 7 females, age 58 ± 9 years) who had been on regular hemodialysis treatment for 10-90 months using disposable regenerated cellulose membrane dialyzers. The prevalence of β2-microglobulin (β2m)-derived AB-amyloid deposits in different sites was determined. At autopsy, specimens were obtained from different joints, paravertebral tissue, intervertebral discs and from visceral organs. During life, routine laboratory parameters and radiographic studies had been carried out at 6-month intervals. Serum levels of β2m were elevated in all patients (57.5 ± 13.4 mg/l). Synovial AB-amyloid deposits were shown in different joints of 4 patients, aged between 59 and 73 years, and dialysed for 10-90 months, respectively. All had been unremarkable by X-ray and asymptomatic. No amyloid could be detected in the intervertebral discs of 2 further patients suffering from destructive spondylarthropathy. In 11 of the 13 patients, extracellular β2m deposits were observed by immunohistochemistry in different tissues. The results document that (a) AB-amyloidosis may occur in elderly patients even when dialysed for less than 5 years; (b) most cases are completely asymptomatic; the appearance of symptoms must be dependent on additional factors, e. g., site of AB-amyloid deposition and intensity of inflammatory reaction, and (c) AB-amyloid is not the exclusive cause of destructive spondylarthropathy, as 2 typical cases were observed who were devoid of am

 

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