Most of the pathology in the kidney from AL Amyloidosis is glomerular in origin. Cases have been noted of pure selective amyloid deposition in the vessels walls of different organs. The clinical presentation of renal amyloidosis basically depends on the distribution and severity of amyloid deposits. Vascular localization represents an uncommon pattern of renal amyloidosis, generally associated with chronic renal failure with minimal or no proteinuria.
An old series in 1983, of nine patients with secondary (AA type) renal amyloidosis with little or no proteinuria has been reported. Renal failure was the presenting sign of renal disease in seven patients. Renal biopsy revealed a predominantly vascular deposition of amyloid in all patients. Three patients had no glomerular amyloid deposits. This pattern of amyloid deposition was found in 12.5% of our renal biopsies from patient with amyloidosis.
Another recent paper from Japan describes the vascular distribution of amyloid and how that changes when it affects the kidney. This paper looked at patient biopsy samples with AL amyloidosis and divided them into a group with capillary form and a group with small vessel form. The small vessel form was associated with more cardiac involvement, and left ventricular thickening compared to the capillary form. There was no significant differences in rates of survival and renal survival.
In summary, vascular amyloid can been seen in the kidney, usually when you are suspecting it even without nephrotic syndrome.
Image Source: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70652-0
- ► 2017 (42)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- Fascinating Wordle in AJT 2011
- NKF 2011 Live Blogging from Nephrology on Demand
- TOPIC DISCUSSION: Vascular Amyloidosis and the Kid...
- NKF 2011 Live Blogging: Integrating the treatment ...
- TOPIC DISCUSSION: TMA ( AJKD tells the tale of 2 d...
- Nephron Animation website
- CONSULT ROUNDS: Renal Involvement in Bardet-Biedl ...
- USA-Nephronpower Wordle( Nephrology Rules)
- Dichotomous Effects of Rapamycin
- TOPIC DISCUSSION: The impact of stopping inhibitor...
- Health News - Research brings new hope of renal re...
- AJP Podcasts
- IN THE NEWS--> Salt sensitive HTN and temperature?...
- TOPIC DISCUSSION: Renal Denervation for Treatment ...
- CONSULT ROUNDS: Pre Eclampsia
- Online CME resource( Nephrology)
- Pediatrics Grand rounds continue
- TOPIC DISCUSSION: Hypophosphatemia in Nocturnal he...
- Journal CLUB: Pediatric Nephrology
- IN THE NEWS--> Statins and the Kidney after surger...
- Arteries and Kidney Transplant
- Pancreas Transplantation in the Treatment of Diabe...
- IN THE NEWS -MDR-1 polymorphisms in steroid resist...
- TOPIC DISCUSSIONS: Glomerular Disease following co...
- May 2011 Hofstra University Kidney Walk
- IN THE NEWS:- RENALASE and CKD
- Transplant Tourism and Malignancy
- IN THE NEWS --->Innovative tools in nephrology su...
- TOPIC DISCUSSION: Rheumatoid Arthritis and the Kid...
- Cystic Diseases of the Kidney: A primer
- CLINICAL CASE 35, ANSWERS AND SUMMARY
- Submit Kidney Week 2011 Abstracts
- IVIG - how does it work from the Immunology blog?
- JOURNAL CLUB: CHOICE STUDY
- IN THE NEWS- ANCA in the Elderly
- Medicine for residents: Calcium gluconate in a dig...
- IN THE NEWS--> Detective Nephron's next venture
- Neutropenia from Tacrolimus
- IN THE NEWS-- Serum Bilirubin and chronic dialysis...
- ▼ April (39)
- ► 2010 (461)