Osteorticular amyloidosis in a patient under dialysis treated by total hip arthroplasty: case report and review of the literature.
The authors present the case of a patient affected by kidney failure, who had been undergoing dialysis for several years when areas of osteolysis and bone resorption in the proximal femur and pathologic fracture appeared. She was treated surgically by hybrid total hip arthroplasty. The patient also complained of pains in other joints. The bone tissue taken from the osteolytic area was examined histologically. The test showed the presence of an amyloid substance. Microradiography and X-ray diffractometry carried out on the same samples confirmed the lack of mineralisation due to the presence of aluminum ions, presumably derived from dialysis. The high concentration of this element was confirmed by resum assay with spectrophometry in atomic absorption. Considering the results of the aforementioned tests, the patient was put on dialysis using a polymethylmethacrylate filter.
Toni
A
A
1a Divisione Ortopedica, Istituti Ortopedici Rizzoli.
Paderni
S
S
Sudanese
A
A
Guerra
E
E
Stea
S
S
Savarino
L
L
Greggi
T
T
D000686:Amyloidosis / Q000175:diagnosis / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000601:surgery; D008875:Middle Aged; D006435:Renal Dialysis