Renal amyloidosis see also Chapter

Amyloidosis occurs in 7-10% of patients with myeloma.1 The most common renal manifestation is nonspecific proteinuria, although microscopic hema-turia may occur. About 25% of patients with AL amyloidosis have serum creatinine values >2 mg/dL. The glomerular filtration rate may be reduced in 50% of patients. About 15% of patients show clinical nephrotic syndrome.56 Among 118 myeloma patients with renal failure and a renal biopsy, renal amyloidosis was found in 25%.53 The kidney size is usually normal or slightly enlarged on imaging studies, but small, contracted kidneys can be seen. Renal biopsy shows amyloid deposition in glomerular mesangium and GBM. Amyloid material stains with Congo red and exhibits apple-green birefringence on polarized light. Electron micrographs reveal characteristic nonbranching fibrils with a distinct diameter of 7.5-10 nm.57

0 0

Post a comment