title: Renal amyloidosis in a drug abuser.
abstract: 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.
authors.affiliation: Department of Medicine, VAMC West Los Angeles, CA 90073, USA.
authors.forename: A U
authors.initials: AU
authors.lastname: Tan
authors.forename: A H
authors.initials: AH
authors.lastname: Cohen
authors.forename: B S
authors.initials: BS
authors.lastname: Levine
mesh_terms: 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*
chemical_list: D003932:Heroin; D003042:Cocaine; D003078:Colchicine