Hemodialysis-associated amyloidosis presenting as lingual nodules.
Hemodialysis has permitted long-term survival of patients with kidney failure, but not without many complications, such as mineral loss from bones, secondary hyperparathyroidism, and increased risk of infection. Recently a new form of amyloidosis, AB2M, has been characterized that is specifically associated with long-term dialysis. The tissues and organs affected by deposits of AB2M appear to differ from those affected by the other major types of amyloidosis; AB2M affects mainly the carpal ligament, synovia of large joints, juxtaarticular bone, and intervetebral disks, while involvement of the oral tissues has been rare. We present here a case in which the biopsy of superficial lingual deposits of AB2M led to the recognition that the patient had developed hemodialysis-associated amyloidosis. It is suggested that periodic inspection of the oral soft tissues for signs or symptoms of amyloidosis should become a part of the dental care of patients undergoing dialysis.
Guccion
J G
JG
Department of Pathology, George Washington University Medical Center.
Redman
R S
RS
Winne
C E
CE
D000686:Amyloidosis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013959:Thyroid Diseases / Q000209:etiology / Q000473:pathology; D013997:Time Factors; D014060:Tongue Diseases / Q000209:etiology* / Q000473:pathology; D001613:beta 2-Microglobulin / Q000032:analysis
D001613:beta 2-Microglobulin