Hassani Kawtar, Hamzi Mohamed Amine, El Kabbaj Driss
Department of Nephrology, Dialysis and Renal Transplantation, Military Training Hospital Mohammed V, Rabat, Morocco.
Saudi J Kidney Dis Transpl. 2018 Mar-Apr;29(2):456-461. doi: 10.4103/1319-2442.229282.
Secondary amyloidosis Amyloid A (AA) is an infrequent but a severe complication of Crohn's disease (CD). This complication results from the activity of the underlying inflammation disease to form amyloid fibril deposits in tissues. We present a case of a 34-year-old female patient with CD treated by azathioprine with inactive disease for three years and who developed a nephrotic syndrome secondary to AA amyloidosis. The treatment by infliximab for one year leads to a complete remission of the nephrotic syndrome. In this case, this complication occurred while the patient was clinically well, with biological and endoscopic markers showing an inactive or only mildly active disease. Infliximab could be a useful tool for a successful treatment of amyloidosis secondary to CD.
继发性淀粉样变性 淀粉样蛋白A(AA)是克罗恩病(CD)一种罕见但严重的并发症。这种并发症是由潜在炎症性疾病的活动导致淀粉样原纤维在组织中沉积所致。我们报告一例34岁女性CD患者,使用硫唑嘌呤治疗,病情缓解三年,继发AA淀粉样变性后出现肾病综合征。使用英夫利昔单抗治疗一年后肾病综合征完全缓解。在该病例中,此并发症发生时患者临床状况良好,生物学和内镜检查指标显示疾病处于静止期或仅轻度活动。英夫利昔单抗可能是成功治疗CD继发性淀粉样变性的有效手段。