Lee Yu Ho, Kim Eun Young, Jeong Da Wun, Kim Yang-Gyun, Lee Sang-Ho, Song Ran, Yang Hyung In, Lim Sung Jig, Moon Ju-Young, Lee Sang-Hoon
From the *Division of Nephrology, and †Division of Rheumatology, Department of Internal Medicine, and ‡Department of Pathology, Kyung Hee University, College of Medicine, Seoul, Korea.
J Clin Rheumatol. 2016 Mar;22(2):86-8. doi: 10.1097/RHU.0000000000000356.
In secondary amyloid A amyloidosis resulting from rheumatologic diseases, tumor necrosis factor α blockers have been reported to be effective in the treatment of both arthritis and amyloidosis. However, there have been few reports concerning the alterations of renal tissue histology before and after long-term tumor necrosis factor α blockers therapy in secondary renal amyloidosis. We report the histological change after tumor necrosis factor α blocker therapy in patient with amyloid A amyloidosis and nephrotic syndrome secondary to underlying ankylosing spondylitis. The patient achieved complete remission of nephrotic syndrome after 17 months of etanercept treatment. We performed the second kidney biopsy after 40 months, and there was little change in the degree of amyloid deposition in the mesangial area and capillary loops compared with the first biopsy. The interstitial inflammation and foot process effacement, however, were fully recovered.
在由风湿性疾病引起的继发性淀粉样蛋白A淀粉样变性中，据报道肿瘤坏死因子α阻滞剂对关节炎和淀粉样变性均有治疗效果。然而，关于继发性肾淀粉样变性长期接受肿瘤坏死因子α阻滞剂治疗前后肾组织组织学改变的报道较少。我们报告了一名患有淀粉样蛋白A淀粉样变性和继发于潜在强直性脊柱炎的肾病综合征患者在接受肿瘤坏死因子α阻滞剂治疗后的组织学变化。该患者在接受依那西普治疗17个月后肾病综合征完全缓解。我们在40个月后进行了第二次肾活检，与第一次活检相比，系膜区和毛细血管袢中淀粉样蛋白沉积程度几乎没有变化。然而，间质炎症和足突消失已完全恢复。
