Amyloid A-type renal amyloidosis in a patient with sarcoidosis: report of a case and review of the literature.
A 53-year-old man developed chronic renal failure during a protracted course of sarcoidosis. A renal biopsy showed Congo red-positive homogenous deposits in the subendothelial space of glomerular capillary walls and arterial walls. On electron microscopy, amyloid fibrils were observed in the deposits. Immunohistochemistry showed positive staining for amyloid A (AA) protein. Treatment with prednisolone resulted in poor response, followed by progressive deterioration of renal function requiring hemodialysis. To our knowledge, there are 5 cases with histologically proven renal amyloidosis accompanied by sarcoidosis. Prognosis in these patients is extremely poor. AA-type amyloidosis should be considered as a rare renal complication in the setting of long-standing sarcoidosis.
Third Department of Internal Medicine, Akita University School of Medicine, Akita City, Akita, Jaan. komatsud@med.akita-u.ac.jp
A
A
Komatsuda
H
H
Wakui
H
H
Ohtani
N
N
Maki
T
T
Nimura
H
H
Takatsu
A
A
Yamaguchi
H
H
Imai
K
K
Sawada
D000686:Amyloidosis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications*; D000685:Serum Amyloid A Protein / Q000378:metabolism*
D000685:Serum Amyloid A Protein