Renal Amyloidosis
- 1 September 2013
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 8 (9), 1515-1523
- https://doi.org/10.2215/cjn.10491012
Abstract
Background and objectives The kidney is the organ most commonly involved in systemic amyloidosis. This study reports the largest clinicopathologic series of renal amyloidosis. Design, setting, participants, & measurements This study provides characteristics of 474 renal amyloidosis cases evaluated at the Mayo Clinic Renal Pathology Laboratory from 2007 to 2011, including age, sex, serum creatinine, proteinuria, type of amyloid, and tissue distribution according to type. Results The type of amyloid was Ig amyloidosis in 407 patients (85.9%), AA amyloidosis in 33 (7.0%), leukocyte chemotactic factor 2 amyloidosis in 13 (2.7%), fibrinogen A α chain amyloidosis in 6 (1.3%), Apo AI, Apo AII, or Apo AIV amyloidosis in 3 (0.6%), combined AA amyloidosis/Ig heavy and light chain amyloidosis in 1 (0.2%), and unclassified in 11 (2.3%). Laser microdissection/mass spectrometry, performed in 147 cases, was needed to determine the origin of amyloid in 74 of the 474 cases (16%), whereas immunofluorescence failed to diagnose 28 of 384 light chain amyloidosis cases (7.3%). Leukocyte chemotactic factor 2 amyloidosis and Apo AI, Apo AII, or Apo AIV amyloidosis were characterized by diffuse interstitial deposition, whereas fibrinogen A α chain amyloidosis showed obliterative glomerular involvement. Compared with other types, Ig amyloidosis was associated with lower serum creatinine, higher degree of proteinuria, and amyloid spicules. Conclusions In the authors’ experience, the vast majority of renal amyloidosis cases are Ig derived. The newly identified leukocyte chemotactic factor 2 amyloidosis form was the most common of the rarer causes of renal amyloidosis. With the advent of laser microdissection/mass spectrometry for amyloid typing, the origin of renal amyloidosis can be determined in >97% of cases.Keywords
This publication has 35 references indexed in Scilit:
- IgG1λ light and heavy chain renal amyloidosisKidney International, 2006
- Immunohistochemical Classification of Amyloid in Surgical Pathology RevisitedThe American Journal of Surgical Pathology, 2006
- Immunoglobulin Light and Heavy Chain Amyloidosis AL/AH: Renal Pathology and Differential DiagnosisPublished by S. Karger AG ,2006
- AL-amyloidosis is underdiagnosed in renal biopsiesNephrology Dialysis Transplantation, 2004
- Histomorphological patterns of renal amyloidosis: A correlation between histology and chemical type of amyloidosisHuman Pathology, 1997
- Purification and primary amino acid sequence of a novel neutrophil chemotactic factor LECT2Immunology Letters, 1996
- Homozygous familial amyloidosis, Finnish type: demonstration of glomerular gelsolin-derived amyloid and non-amyloid tubular gelsolin.1993
- Human lysozyme gene mutations cause hereditary systemic amyloidosisNature, 1993
- Apolipoprotein AI mutation Arg-60 causes autosomal dominant amyloidosis.Proceedings of the National Academy of Sciences of the United States of America, 1992
- A PECULIAR FORM OF PERIPHERAL NEUROPATHYBrain, 1952