Van Audenhove A, Vandermarliere A, Lerut E, Lodewyckx T, Vanrenterghem Y, Maes B
Department of Nephrology, Europe Hospitals-2 Alice, Groeselenberg 57, B-1180 Brussels, Belgium.
Acta Clin Belg. 2003 Jul-Aug;58(4):248-50. doi: 10.1179/acb.2003.58.4.007.
Dialysis-related amyloidosis is a disorder that commonly develops in long-term dialysis with an incidence that is linked to the duration of hemodialysis. The amyloid deposits are composed of the amyloid precursor beta 2 microglobulin, mainly affecting the osteoarticular system, but also involving extra-osteoarticular tissues. We present a patient with repeated rectal bleeding caused by a circumferential atone ulcer in the immediate posttransplantation period due to the use of a rectal canula after 27 years of treatment with hemodialysis. Histopathological examination of the rectal ulcer biopsy specimens revealed positive Congo red stain and additional immunohistochemical investigation showed the presence of beta 2-microglobulin in a blood vessel wall of the rectum. Although dialysis related amyloidosis may be partially prevented, it is important to remain alert for dialysis related amyloidosis complications after renal transplantation in patients with a longstanding history of dialysis.
透析相关性淀粉样变性是一种常见于长期透析患者的疾病，其发病率与血液透析的时长有关。淀粉样沉积物由淀粉样前体β2微球蛋白组成，主要影响骨关节系统，但也累及骨关节外组织。我们报告了一名患者，在接受27年血液透析治疗后，由于移植后立即使用直肠插管导致环形压疮溃疡，反复出现直肠出血。直肠溃疡活检标本的组织病理学检查显示刚果红染色呈阳性，进一步的免疫组织化学研究显示直肠血管壁中存在β2微球蛋白。虽然透析相关性淀粉样变性可能得到部分预防，但对于有长期透析病史的患者，肾移植后仍需警惕透析相关性淀粉样变性并发症。
