Gong Qian, Gao Lutao, Li Hongxia, Zhong Rongzheng, Huo Yanhong
Health Sciences Center, Peking University, Beijing, CHN.
Department of Health Economics, Seventh Medical Center of Chinese PLA General Hospital, Beijing, CHN.
Cureus. 2025 Apr 29;17(4):e83192. doi: 10.7759/cureus.83192. eCollection 2025 Apr.
Leukocyte chemotactic factor 2 (ALECT2) amyloidosis is a rare form of renal amyloidosis, typically presenting with chronic kidney disease and variable degrees of proteinuria. Cases of concurrent ALECT2 amyloidosis and IgA nephropathy are exceedingly rare, with limited descriptions of their clinical and pathological features in the literature. Here, we report a 61-year-old Chinese woman who presented with symmetrical lower limb edema and microscopic hematuria, without nephrotic syndrome or significant proteinuria. Renal biopsy revealed diffuse interstitial amyloid deposition and coexisting IgA nephropathy. Laser microdissection combined with mass spectrometry (LMD/MS) confirmed the presence of LECT2 amyloid protein. The patient was diagnosed with ALECT2 amyloidosis with concurrent IgA nephropathy. She was treated with sodium-glucose transport protein 2 (SGLT-2) inhibitors, and her renal function stabilized at a six-month follow-up. Combining immunological techniques and LMD/MS is recommended for the diagnosis of renal ALECT2 amyloidosis.
白细胞趋化因子2（ALECT2）淀粉样变性是肾淀粉样变性的一种罕见形式，通常表现为慢性肾脏病和不同程度的蛋白尿。ALECT2淀粉样变性与IgA肾病并发的病例极为罕见，文献中对其临床和病理特征的描述有限。在此，我们报告一名61岁的中国女性，她表现为对称性下肢水肿和镜下血尿，无肾病综合征或大量蛋白尿。肾活检显示弥漫性间质淀粉样沉积并并存IgA肾病。激光显微切割联合质谱分析（LMD/MS）证实存在LECT2淀粉样蛋白。该患者被诊断为ALECT2淀粉样变性并发IgA肾病。她接受了钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂治疗，在6个月的随访中肾功能稳定。推荐联合免疫技术和LMD/MS用于诊断肾ALECT2淀粉样变性。
