Renal AA amyloidosis leading to early diagnosis and treatment of takayasu arteritis: a case report and review of the lit
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LETTER TO THE EDITORS
Renal AA amyloidosis leading to early diagnosis and treatment of takayasu arteritis: a case report and review of the literature Igor Kos1 · Stephan Stilgenbauer1 · Moritz Bewarder1 Received: 19 March 2020 / Accepted: 23 April 2020 © The Author(s) 2020
Keywords AA amyloidosis · Takayasu arteritis · Proteinuria · Tocilizumab Sirs: A 31-year-old female patient from India presented to our institution with proteinuria. The initial screening by dipstick urinalysis showed a proteinuria level of 1000 mg/dL, while the 24-h urine collection registered 4.01 g of protein and 602 mg of creatinine. These abnormalities were diagnosed during her second pregnancy and persisted for 5 months after delivery. Retrospectively, proteinuria was already present during her first pregnancy 2 years before but was not followed up thereafter. Apart from occasional mild shoulder pain, the patient reported no complaints, in particular, no B-symptoms and Raynaud’s phenomenon was absent. The physical examination was unremarkable, there was no edema or dermatological alterations, and all peripheral pulses were palpable. Due to the unclear origin of the nephrotic syndrome, a biopsy of the kidney was performed. The histological results showed vascular and glomerular AA amyloidosis, which was also verified by high levels of serum amyloid A (48 mg/ dl—reference value
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