Yılmaz Songül, Özçakar Z Birsin, Bulum Burcu, Kiremitçi Saba, Ensari Arzu, Ekim Mesiha, Keven Kenan, Yalçınkaya Fatoş
Department of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey.
Pediatr Transplant. 2014 Dec;18(8):E259-61. doi: 10.1111/petr.12344. Epub 2014 Sep 1.
Systemic AA amyloidosis is a serious complication of many chronic inflammatory disorders and chronic infections. Renal involvement is seen in the majority of the patients and can lead to end-stage renal disease. Renal transplantation can be performed in these patients; however, amyloidosis can recur in the transplanted kidneys. On the other hand, de novo AA amyloidosis in renal transplant patients has been rarely reported. We report a 17-yr-old patient with end-stage renal disease due to genitourinary anomalies who developed recurrent pyelonephritis after transplantation. Three yr after transplantation, renal biopsy was performed for proteinuria and AA amyloidosis was identified in the renal allograft. Although rare, chronic infections might cause de novo amyloidosis in renal transplant patients. Therefore, amyloidosis should be kept in mind in those types of patients who present with proteinuria.
系统性AA淀粉样变性是许多慢性炎症性疾病和慢性感染的严重并发症。大多数患者会出现肾脏受累，可导致终末期肾病。这些患者可以进行肾移植；然而，淀粉样变性可在移植肾中复发。另一方面，肾移植患者新发AA淀粉样变性鲜有报道。我们报告一例17岁因泌尿生殖系统异常导致终末期肾病的患者，移植后发生复发性肾盂肾炎。移植后3年，因蛋白尿进行肾活检，在移植肾中发现AA淀粉样变性。尽管罕见，但慢性感染可能导致肾移植患者新发淀粉样变性。因此，对于出现蛋白尿的这类患者应考虑到淀粉样变性。
