Characteristics of chronic kidney disease patients admitted to our hospital to investigate the cause of fever

Sato, Keitaro; Otsubo, Shigeru; Sugi, Orie; Ogawa, Masaru; Sahara, Yukako; Iwasa, Yuko; Asamiya, Yukari; Kikuchi, Kan; Takei, Takashi; Ogawa, Tetsuya; Miwa, Naoko; Naoki, Katsuhiko; Uchida, Keiko; Tsuchiya, Ken; Akiba, Takashi; Nitta, Kosaku

doi:10.4009/jsdt.41.317

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Some studies have reported the presence of fever in patients with DRA and a 20-year history of HD [8,9]. Our patient underwent maintenance HD for 24 years since 1983, and she had numerous DRA deposits in several joints.…”

Section: Discussionmentioning

confidence: 71%

“…Miyata et al [6,7] have reported that advanced glycation end product (AGE)-b 2 M may function as a pathogenic factor responsible for induction of the inflammatory response that ultimately leads to joint/bone destruction in DRA. However, only some reports have documented b 2 M-based induction of the systemic inflammatory response in patients on long-term HD [8,9]. In this report, we describe a patient on long-term HD who developed severe DRA and recurrent fever with arthralgia.…”

Section: Introductionmentioning

confidence: 78%

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Fever associated with severe dialysis-related amyloidosis

et al. 2012

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Dialysis-related amyloidosis (DRA) is one of the most important complications in patients on long-term hemodialysis (HD). DRA often affects the osteoarticular system; however, little is known about the role of b 2 -microglobulin in the induction of fever in HD patients. We report a 64-year-old woman on long-term (24 years) HD who developed polyarthralgia and intermittent fever. Infectious diseases, connective tissue diseases, and malignant neoplasm were ruled out. Computed tomography and magnetic resonance imaging showed swelling of the soft tissues around bilateral shoulder and hip joints, suggestive of amyloid deposits. Gallium scintigraphy showed abnormal uptake in the vicinity of several large joints. It was presumed that the fever was related to the amyloid joint deposits, and the patient was treated with prednisolone and b 2 -microglobulin adsorption therapy. The treatment resulted in the resolution of fever, relief of arthralgia, and normalization of several inflammatory cytokines and C-reactive protein. The findings suggest that massive DRA could cause systemic inflammatory response in patients on long-term HD.Keywords Dialysis-related amyloidosis Á b 2 -Microglobulin Á Long-term hemodialysis Á Systemic inflammatory response Abbreviations AGE Advanced glycation end product b 2 M b 2 -Microglobulin CRP C-reactive protein DRA Dialysis-related amyloidosis HD Hemodialysis PSL Prednisolone

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 78%

Fever associated with severe dialysis-related amyloidosis

et al. 2012

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“…Therefore, we considered that this case was FMF which developed in a long-term hemodialysis patient with DRA. DRA can cause fever 14 and arthropathy, 13 which are similar to the clinical signs of FMF. The Tel-Hashomer criteria for FMF are based on characteristic clinical symptoms alone; therefore, DRA may overlap with FMF clinical signs making a correct diagnosis difficult.…”

Section: Discussionmentioning

confidence: 91%

Atypical familial Mediterranean fever developed in a long‐term hemodialysis patient

Makino

Ohara

Kobayashi

et al. 2018

Hemodialysis International

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Familial Mediterranean Fever (FMF) is usually an autosomal recessive autoinflammatory disease characterized by recurrent attacks of fever and serositis. FMF develops before the age of 20 years in 90% of patients. It has intervals of 1 week to several years between attacks, which leads to renal dysfunction-amyloidosis. We report a case of atypical FMF that developed in a long-term hemodialysis patient. A 65-year-old Japanese female undergoing hemodialysis for 32 years was referred to our hospital with a fever of unknown origin (FUO) following cervical laminoplasty. The fever occurred as recurrent attacks accompanied by oligoarthralgia of the left hip and knee. We suspected FMF because of recurrent self-limited febrile attacks, although the patient showed atypical clinical features such as late-onset and highly frequent attacks. After receiving treatment, she achieved a complete response to colchicine. Therefore, a diagnosis of FMF was made based on the Tel-Hashomer criteria, which was confirmed by genetic testing. The case suggests that FMF may be of note in long-term hemodialysis patients developing FUO.

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“…In all cases, the condition initially presented as a fever of unknown origin. A retrospective analysis of 42 hemodialysis patients who presented with a fever of unknown origin revealed that the cause of the fever had been dialysis-related amyloidosis in 6 of those 42 cases ( 9 ). Interestingly, we did not find any case report of this condition from outside Japan.…”

Section: Discussionmentioning

confidence: 99%

Dialysis-related Amyloidosis Presenting as a Fever of Unknown Origin: Symptoms and Management

et al. 2023

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A 74-year-old woman with a 34-year history of hemodialysis presented with an intermittent fever, which later coincided with recurrent bilateral shoulder and hip joint pain. Imaging studies suggested amyloid arthropathy, which was histologically confirmed by a synovial biopsy. Increasing β2-microglobulin clearance during dialysis alone attenuated the intermittent fever and joint pain, but the symptoms did not disappear until the administration of prednisolone 10 mg/day. Reported cases of dialysis-related amyloidosis with a fever imply that changing to blood purification methods with high β2-microglobulin clearance is crucial for controlling the condition long-term, whereas concurrent use of anti-inflammatory agents promptly alleviates the symptoms.

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Characteristics of chronic kidney disease patients admitted to our hospital to investigate the cause of fever

Cited by 4 publications

References 6 publications

Fever associated with severe dialysis-related amyloidosis

Fever associated with severe dialysis-related amyloidosis

Atypical familial Mediterranean fever developed in a long‐term hemodialysis patient

Dialysis-related Amyloidosis Presenting as a Fever of Unknown Origin: Symptoms and Management

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