Bardin T, Kuntz D, Zingraff J, Voisin M C, Zelmar A, Lansaman J
Arthritis Rheum. 1985 Sep;28(9):1052-8. doi: 10.1002/art.1780280913.
Synovial amyloid deposits were found in 18 patients with end-stage renal failure due to various nonamyloid nephropathies, who had been treated with long-term, periodic hemodialysis (mean 116 months). All patients had carpal tunnel syndrome, which was bilateral in 14 of them; 4 patients also had finger flexor tenosynovitis. In 2 patients, destructive arthropathies required surgical replacement of the hip. Amyloid deposits were demonstrated by light microscopy in the synovium of the finger flexor tendon and/or transverse carpal ligament of all patients who had surgery for carpal tunnel syndrome, and in the synovium and capsula of the 2 surgically removed hips. Transmission electron microscopy of synovial samples from 6 patients demonstrated the characteristic fibrillar ultrastructure of amyloid deposits, the biochemical nature of which is still unknown. In addition, 9 patients had cystic radiolucencies of bone, which were interpreted as having resulted from local amyloid deposits, involving carpal bones, humeral heads, femoral heads, acetabula, or tibial plateaus. Our results show that amyloidosis is a frequent histologic finding in dialysis patients receiving surgical management of carpal tunnel syndrome, and that it can also be associated with cystic radiolucencies of bones and with destructive arthropathies.
在18例因各种非淀粉样肾病导致终末期肾衰竭且接受长期定期血液透析（平均116个月）的患者中发现了滑膜淀粉样沉积。所有患者均患有腕管综合征，其中14例为双侧患病；4例患者还患有手指屈肌腱腱鞘炎。2例患者出现破坏性关节病，需要进行髋关节置换手术。在所有接受腕管综合征手术的患者的手指屈肌腱滑膜和/或腕横韧带以及2例接受手术切除的髋关节的滑膜和关节囊中，通过光学显微镜证实了淀粉样沉积。对6例患者的滑膜样本进行透射电子显微镜检查，显示出淀粉样沉积特征性的纤维超微结构，其生化性质尚不清楚。此外，9例患者出现骨囊性透亮区，被认为是由局部淀粉样沉积引起的，累及腕骨、肱骨头、股骨头、髋臼或胫骨平台。我们的结果表明，淀粉样变性是接受腕管综合征手术治疗的透析患者常见的组织学表现，并且它还可能与骨囊性透亮区以及破坏性关节病相关。
