Guccion J G, Redman R S, Winne C E
Department of Pathology, George Washington University Medical Center.
Oral Surg Oral Med Oral Pathol. 1989 Nov;68(5):618-23. doi: 10.1016/0030-4220(89)90250-8.
Hemodialysis has permitted long-term survival of patients with kidney failure, but not without many complications, such as mineral loss from bones, secondary hyperparathyroidism, and increased risk of infection. Recently a new form of amyloidosis, AB2M, has been characterized that is specifically associated with long-term dialysis. The tissues and organs affected by deposits of AB2M appear to differ from those affected by the other major types of amyloidosis; AB2M affects mainly the carpal ligament, synovia of large joints, juxtaarticular bone, and intervetebral disks, while involvement of the oral tissues has been rare. We present here a case in which the biopsy of superficial lingual deposits of AB2M led to the recognition that the patient had developed hemodialysis-associated amyloidosis. It is suggested that periodic inspection of the oral soft tissues for signs or symptoms of amyloidosis should become a part of the dental care of patients undergoing dialysis.
血液透析使肾衰竭患者得以长期存活，但并非没有许多并发症，如骨质矿物质流失、继发性甲状旁腺功能亢进以及感染风险增加。最近，一种新的淀粉样变性形式，即AB2M淀粉样变性，已被明确，它与长期透析特别相关。受AB2M沉积影响的组织和器官似乎与受其他主要类型淀粉样变性影响的组织和器官不同；AB2M主要影响腕横韧带、大关节滑膜、关节周围骨和椎间盘，而口腔组织受累情况罕见。我们在此报告一例病例，对舌表面AB2M沉积物进行活检后，发现该患者已发生血液透析相关淀粉样变性。建议定期检查口腔软组织是否有淀粉样变性的体征或症状，应成为透析患者牙科护理的一部分。
