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Two cases of secondary AA amyloidosis involving the skin and chronic kidney infection with a nephrotic syndrome in a high-income country
  1. Florian Garo1,
  2. Juliette Chatelain1,
  3. Cedric Aglae1,2 and
  4. Olivier Moranne1,2
  1. 1Nephrology Dialysis Apheresis, Hopital Universitaire de Nimes, CHU Caremeau, Nimes, France
  2. 2Faculty of Medicine, University of Montpellier, Montpellier, France
  1. Correspondence to Professor Olivier Moranne; olivier.moranne{at}chu-nimes.fr

Abstract

We present two French cases of amyloid-associated (AA) amyloidosis secondary to chronic infections. Patient 1, a 51-year-old heroin addict, was hospitalised for chest pain and anasarca. During hospitalisation, a nephrotic syndrome with an inflammatory condition was discovered along with a chronic skin ulcer on his arm. Salivary gland and kidney biopsies confirmed the diagnosis of AA amyloidosis. Renal function quickly declined and haemodialysis was initiated 6 months later. Patient 2, a 55-year-old woman, was hospitalised for obstructive pyelonephritis secondary to coraliform lithiasis. Renal insufficiency with an impure nephrotic syndrome was found. After nephrectomy due to chronic pyelonephritis and an atrophic cortex on the abdominal scan, the histology revealed AA amyloidosis. Despite treatment with ACE inhibitors and control of inflammation, the nephrotic syndrome persisted with rapid decline of the kidney function.

  • renal medicine
  • nephrotic syndrome
  • public health

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Footnotes

  • Twitter @garoflorian

  • Contributors Supervised by OM. The patient was under the care of OM and CA. Illustrations were provided by FG. Report was written by JC and OM. It was reread by OM, CA and FG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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