Extracapillary glomerulonephritis and renal amyloidosis.
We report three patients with well-documented renal amyloidosis who developed rapidly progressive renal failure. Renal biopsies from all three patients showed crescentic glomerulonephritis imposed on renal amyloidosis. All patients were treated with intravenous high-dose methylprednisolone pulses combined with immunosuppressive agents and oral corticosteroids. Partial recovery of renal function was obtained in two patients. For the third patient, treatment had to be stopped after a few days because of a septic arthritis. Renal function continued to deteriorate, and the patient had to be placed on regular hemodialysis. We conclude that extracapillary glomerulonephritis may occasionally complicate a preexisting renal amyloidosis and may be reversible if recognized early and treated appropriately.
Moroni
G
G
Unit of Nephrology, Ospedale Maggiore, IRCCS, Milano, Italy.
Banfi
G
G
Maccario
M
M
Mereghetti
M
M
Ponticelli
C
C
D000368:Aged; D000686:Amyloidosis / Q000150:complications* / Q000473:pathology; D001379:Azathioprine / Q000627:therapeutic use; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005921:Glomerulonephritis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000150:complications* / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011241:Prednisone / Q000627:therapeutic use; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000209:etiology
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D001379:Azathioprine; D011241:Prednisone; D008775:Methylprednisolone