Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Am J Kidney Dis. 2011 Jun;57(6):941-4. doi: 10.1053/j.ajkd.2011.02.383. Epub 2011 Apr 15.
Recurrent AA amyloidosis in a kidney transplant is rare, especially when the underlying inflammatory condition is controlled. We present a 59-year-old man who underwent a living donor kidney transplant 17 years ago for kidney failure due to AA amyloid nephropathy in the setting of long-standing Crohn disease. His Crohn disease was quiescent before and after the kidney transplant. Transplant function had been stable until a month before presentation, when he developed worsening proteinuria and decreased kidney function. A transplant biopsy showed recurrent AA amyloidosis despite excellent clinical and histologic control of Crohn disease.
肾移植后复发性 AA 淀粉样变性较为罕见，尤其是在基础炎症性疾病得到控制的情况下。我们报告了一例 59 岁男性患者，17 年前因 AA 淀粉样变性肾病导致肾衰竭接受活体供肾移植，此前和此后均患有长期的克罗恩病。他的克罗恩病在肾移植前后均处于静止期。移植肾功能一直稳定，直到就诊前 1 个月，他出现蛋白尿加重和肾功能下降。移植肾活检显示尽管克罗恩病的临床和组织学控制良好，但仍存在复发性 AA 淀粉样变性。
