Renal amyloidosis in a drug abuser.
Drug abusers, particularly those who inject drugs s.c. ("skin popping"), may develop amyloidosis. Chronic infections are thought to play a pathogenetic role in this setting. A patient is presented who had a history of "skin popping" cocaine and heroin and developed nephrotic syndrome, with an elevated serum creatinine and a creatinine clearance of 61 mL/min. Renal biopsy demonstrated amyloidosis. Treatment with colchicine was initiated, and proteinuria decreased to near normal levels after 12 months. Concomitant with the decrease in proteinuria, creatinine clearance improved, although a repeat renal biopsy failed to show any significant improvement in amyloid burden. These observations suggest that colchicine may be a useful treatment in reversing the proteinuria of renal amyloidosis associated with drug abuse. Furthermore, clinical improvement may occur before any demonstrable regression in the amyloidosis.
Tan
A U
AU
Department of Medicine, VAMC West Los Angeles, CA 90073, USA.
Cohen
A H
AH
Levine
B S
BS
D000328:Adult; D000686:Amyloidosis / Q000188:drug therapy / Q000209:etiology*; D003042:Cocaine / Q000008:administration & dosage; D003078:Colchicine / Q000627:therapeutic use; D005260:Female; D003932:Heroin / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D007674:Kidney Diseases / Q000188:drug therapy / Q000209:etiology*; D019966:Substance-Related Disorders / Q000150:complications*
D003932:Heroin; D003042:Cocaine; D003078:Colchicine