Clinical and pathological features of renal amyloidosis: an analysis of 32 patients in a single Chinese centre.
OBJECTIVE
To summarize the clinical and pathological features of renal amyloidosis in order to achieve early diagnosis.


METHODS
The clinical and pathological data of 32 patients with renal amyloidosis, diagnosed by renal biopsy in one renal centre, were retrospectively analyzed. Immunohistochemistry of amyloid A protein and immunoglobulin light chains was further performed on the renal specimens for further classification.


RESULTS
Twenty-four out of the 32 patients (75%) were not considered to have renal amyloidosis by local physicians; 91.7% (22/24) of them had at least one of the following signs: bodyweight loss, organ enlargement and decreased blood pressure. Twenty-nine out of the 32 patients (90.6%) were over 40 years, 30 patients (93.8%) had nephrotic syndrome, and 21 patients (65.6%) were found to have monoclonal light chain in serum or urine by immunofixation. Six patients (18.8%) were negative by Congo red stain and were diagnosed as having early renal amyloidosis by electron microscopy. Twenty-eight patients were diagnosed as having AL amyloidosis, two were suspected of having AL amyloidosis, one had AA amyloidosis and the status of the remaining patient was undetermined.


CONCLUSIONS
Renal amyloidosis is frequently neglected by local physicians in China. Middle-aged nephrotic patients with weight loss, organ enlargement and monoclonal light chains in serum or urine should be highly suspected of the disease. Renal biopsies, especially electron microscopy, play a crucial role in the early diagnosis of renal amyloidosis.
Qu
Zhen
Z
Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
Zheng
Xin
X
Wang
Su-Xia
SX
Ao
Jie
J
Zhou
Fu-De
FD
Chen
Min
M
Liu
Gang
G
D000328:Adult; D000686:Amyloidosis / Q000175:diagnosis* / Q000473:pathology; D002681:China; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies