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      Destructive Spondyloarthropathy with β 2-Microglobulin Amyloid Deposits in a Uremic Patient before Chronic Hemodialysis


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          We report a case of erosive arthropathies discovered radiologically before dialysis in a uremic patient with Alport syndrome. This patient had no hereditary amyloidosis or causes of acquired generalized amyloidosis (no chronic infections or inflammatory disease, neoplasia, lymphoma or monoclonal gammapathy). Erosive spondyloar-thropathies of the cervical spine at the C5-C6 and C6-C7 levels, erosive arthropathy of the right acromioclavicular joint, metacarpal lacuna of the right hand, and lacuna of the left femoral neck were discovered 24 months before starting dialysis in this patient with chronic renal insufficiency of 17 years duration. Puncture of the vertebral disc before starting dialysis took a fragment showing amyloid deposits with permanganate-sensitive Congo red staining and positive staining with anti-β<sub>2</sub>-microglobulin antibodies. This observation suggests that β<sub>2</sub>-microglobulin amyloidosis in uremia may not be exclusively related to chronic kidney replacement therapy, but to uremia per se, especially when the latter is of long duration.

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          Author and article information

          S. Karger AG
          11 December 2008
          : 59
          : 4
          : 654-657
          aService de Néphrologie-Hémodialyse, bService d’Anatomie pathologique, cService de Rhumatologie et dService de Radiologie, Centre Hospitalier Régional et Universitaire, Hôpital Sud, Amiens, France
          186661 Nephron 1991;59:654–657
          © 1991 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          : 22 March 1991
          Page count
          Pages: 4
          Case Report

          Cardiovascular Medicine,Nephrology
          Spondyloarthropathy, erosive,Hemodialysis, chronic,Amyloidosis,&beta;2-Microglobulin


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