Demin A A, Semenova L A, Sentiakova T N, Poliachenko E A, Smirnov V V, Potaliukova E V, Demina L M
Klin Med (Mosk). 1992 Feb;70(2):61-6.
Based on the authors' experience from 1982 to 1990 it was noted that out of 26 cases of renal amyloidosis in the presence of nonpurulent and purulent conditions 2 patients (7%) demonstrated the association with systemic lupus erythematosus (SLE). It was also noted that amyloidosis developed in the patients with a long history of the disease. Long-course immunosuppression treatment could be regarded as the other factor-of-risk for amyloidosis development. Histochemical examination of both patients demonstrated that amyloid deposits in the renal glomeruli were resistant to the potassium permanganate effect and consisted of AL-protein. The results obtained indicated the possibility of appearance of immunoglobulins AL--the proteins of the primary amyloidosis--synthesized in the spectrum in the SLE presence as well as their deposition in the renal glomeruli. As a possible cause of proteinuria and the nephrotic syndrome in SLE patients amyloidosis should be diagnosed in the life time and be regarded in the choice of therapeutic policy as well as in the assessment of pulse immunosuppressive therapy practicability.
根据作者1982年至1990年的经验,发现在26例伴有非化脓性和化脓性病症的肾淀粉样变性病例中,有2例患者(7%)表现出与系统性红斑狼疮(SLE)相关。还注意到淀粉样变性在病程较长的患者中发生。长期免疫抑制治疗可被视为淀粉样变性发生的另一个危险因素。对这两名患者的组织化学检查表明,肾小球中的淀粉样沉积物对高锰酸钾作用有抗性,且由AL蛋白组成。所获得的结果表明,在SLE存在的情况下,有可能出现免疫球蛋白AL(原发性淀粉样变性的蛋白)在光谱中合成,并沉积在肾小球中。作为SLE患者蛋白尿和肾病综合征的可能原因,淀粉样变性应在患者生前得到诊断,并在选择治疗策略以及评估脉冲免疫抑制治疗的可行性时予以考虑。