[Renal amyloidosis complicating the outcome of chronic inflammatory colitis].
BACKGROUND
In 4 patients we observed the association of an amyloid nephropathy and a chronic inflammatory bowel disease (Crohn's' disease in 3 cases and ulcerative rectocolitis in 1 case).


METHODS
These patients, aged a mean of 37 years (range: 28-48 years), had been admitted for exploration of a nephrotic syndrome associated with renal failure in 2 cases. The investigations lead to the diagnosis of AA type amyloidosis in the 4 cases. One patient was lost from follow-up. One patient was treated with salazopyrine, one with corticosteroids and one with colchicine. After a mean follow-up of 16 months (5-30 months), all the patients had persistent nephrotic syndrome, with end stage renal failure in one case, persistence of normal renal function in one case and improved renal function in one case. None of the patients exhibited remission in the nephrotic syndrome. The response of amyloidosis to the treatment of the chronic inflammatory bowel disease varied. Corticosteroids and colchicine stabilised renal function in 2 of our patients but without remission in the nephrotic syndrome.


CONCLUSIONS
AA amyloidosis is a rare complication of inflammatory bowel disease. The indication for colchicine is important to consider particularly since the response of amyloidosis to the treatment of the causal disease does not, in the majority of cases, lead to the remission of the amyloidosis, the prognosis of which is determined by the extent of renal involvement.
Béji
Soumaya
S
Service de néphrologie et de médecine interne, Hôpital Charles Nicolle, Tunis, Tunisie.
Kaaroud
Hayet
H
Ben Moussa
Fatma
F
Goucha
Rym
R
Abderrahim
Ezzedine
E
El Younsi
Fethi
F
Ben Maïz
Hédi
H
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000686:Amyloidosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003078:Colchicine / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D000305:Adrenal Cortex Hormones; D006074:Gout Suppressants; D003078:Colchicine
Amylose renale compliquant l'évolution de colites inflammatoires chroniques.