Cornelis Tom, Bammens Bert, Lerut Evelyne, Cosyn Luc, Goovaerts Gerda, Westhovens René, Vanrenterghem Yves
Department of Nephrology and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium.
Nephrol Dial Transplant. 2008 Oct;23(10):3362-4. doi: 10.1093/ndt/gfn392. Epub 2008 Jul 16.
We report a case of a woman with secondary oxalosis after jejunoileal bypass surgery for obesity, who presented with oxalate stone disease and renal insufficiency requiring dialysis. Thirty years after surgery, longstanding osteoarticular symptoms were recognized as oxalate arthritis. Eventually, she also developed oxalate vasculitis, which improved with corticoid treatment and intensification of dialysis. Work-up for kidney transplantation revealed AA amyloidosis on gastric and colonic biopsies. Since no other cause of chronic inflammation could be identified, it was concluded that the amyloidosis was secondary to oxalate arthritis and vasculitis. To our knowledge, this is the first report on this association.
我们报告一例肥胖患者在空肠回肠旁路手术后发生继发性草酸中毒的病例,该患者出现草酸盐结石病和需要透析的肾功能不全。手术后30年,长期存在的骨关节症状被确认为草酸盐关节炎。最终,她还发展为草酸盐血管炎,经皮质激素治疗和强化透析后病情有所改善。肾移植检查发现胃和结肠活检显示有AA型淀粉样变性。由于未发现其他慢性炎症原因,得出结论认为淀粉样变性继发于草酸盐关节炎和血管炎。据我们所知,这是关于这种关联的首次报告。