Picciani Bruna, Gornic Camila, Cunha Karin Soares, Janini Maria Elisa Rangel, Andrade Raquel Machado, Meireles Valdir, Soares-Filho Porphirio, Pedra Dias Eliane
Department of Pathology, School of Medicine, Fluminense Federal University, Rio de Janeiro, Brazil.
School of Dentistry, Federal University of Rio of Janeiro, Rio de Janeiro, Brazil.
Spec Care Dentist. 2018 Nov;38(6):434-437. doi: 10.1111/scd.12331. Epub 2018 Sep 14.
The β2-microglobulin amyloidosis is a newly recognized type of systemic amyloidosis, which occurs in patients with chronic renal failure undergoing long-term hemodialysis. The dialysis-related amyloidosis (DRA) of the tongue is an uncommon and late complication, which occurs in patients undergoing chronic hemodialysis for more than 20 years. The aim of this paper is to report two cases of lingual amyloidosis associated with long-term hemodialysis. Two patients were referred to the Oral Medicine Clinic due to the presence of multiple nodules on the tongue and macroglossia. The patients had history of chronic renal failure and had been dialysed for more 20 years with bio-incompatible cellulose membrane. Biopsies of the lesions were performed and the histopathological features and Congo red stain revealed oral amyloidosis. Both patients remain in clinical follow-up after 12 and 6 months, respectively. Recognition of the amyloidosis tongue lesions can minimize the complications caused by this condition such as obstruction of the upper airways, making it imperative to carry out early treatment. Furthermore, in patients with oral amyloidosis, lesions in areas of trauma may ulcerate and cause pain and dysphagia becoming necessary periodic surgical removal and regular follow-up of these patients.
β2微球蛋白淀粉样变性是一种新认识的全身性淀粉样变性类型，发生于长期接受血液透析的慢性肾衰竭患者。舌部的透析相关淀粉样变性（DRA）是一种罕见的晚期并发症，见于接受慢性血液透析超过20年的患者。本文旨在报告2例与长期血液透析相关的舌淀粉样变性病例。两名患者因舌部出现多个结节和巨舌症而被转诊至口腔内科诊所。患者有慢性肾衰竭病史，使用生物不相容的纤维素膜进行透析已超过20年。对病变进行了活检，组织病理学特征和刚果红染色显示为口腔淀粉样变性。两名患者分别在12个月和6个月后仍在临床随访中。认识到淀粉样变性舌部病变可将该疾病引起的并发症（如气道梗阻）降至最低，因此必须尽早进行治疗。此外，在口腔淀粉样变性患者中，创伤部位的病变可能发生溃疡并引起疼痛和吞咽困难，因此需要对这些患者进行定期手术切除和定期随访。
