Reese W, Hopkovitz A, Lifschitz M D
Renal Section, University of Texas Health Science Center, San Antonio 78274.
Am J Kidney Dis. 1988 Oct;12(4):323-5. doi: 10.1016/s0272-6386(88)80228-2.
Chronic hemodialysis has led to the prolongation of life in many patients with end-stage renal disease, but has also allowed for the development of new diseases that are a consequence of this clinical setting. B2-microglobulin accumulation leading to systemic amyloidosis may be the most recent disease in this category. This case report documents the development of bilateral popliteal tumors in a patient undergoing chronic hemodialysis for 9 years. Removal of one of the tumors and pathological examination demonstrated amyloid that was positive for B2-microglobulin by specific antibody testing. This case adds further support to the suggestion that B2-microglobulin amyloidosis in chronic hemodialysis patients is truly a systemic disorder. The development of popliteal tumors, particularly in proximity to joints, in a chronic hemodialysis patient, must include amyloidosis in the differential diagnosis.
慢性血液透析使许多终末期肾病患者的生命得以延长，但同时也引发了一些因这种临床情况导致的新疾病。β2-微球蛋白蓄积导致的系统性淀粉样变可能是此类疾病中最新出现的一种。本病例报告记录了一名接受慢性血液透析9年的患者双侧腘窝肿瘤的发生情况。切除其中一个肿瘤并进行病理检查，结果显示通过特异性抗体检测，淀粉样物质β2-微球蛋白呈阳性。该病例进一步支持了慢性血液透析患者的β2-微球蛋白淀粉样变确实是一种全身性疾病的观点。对于慢性血液透析患者出现的腘窝肿瘤，尤其是靠近关节处的肿瘤，在鉴别诊断时必须考虑到淀粉样变。
