Colchicine in the treatment of renal amyloidosis secondary to familial Mediterranean fever

Sarkissian, Ashot; Papazian, Marina; Sanamyan, Armen; Leumann, Ernst

doi:10.1093/ndt/15.7.1098

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…Many studies emphasized that, early initiation and absolute compliance with colchicine therapy are the most important approaches for regression in preservation of proteinuria in FMF-associated amyloidosis patients. 4,[8][9][10][11][12] The most beneficial effect of early initiation of colchicine therapy on decreasing proteinuria in pediatric amyloidosis patients is also consistent with these results 2,13 Additionally, our study revealed that, response to colchicine treatment should also depend on the etiology of amyloidosis. In the subgroup analysis, the amyloidosis was related with FMF in all of the responder to colchicine treatment.…”

Section: Discussionsupporting

confidence: 84%

Is colchicine therapy effective in all patients with secondary amyloidosis?

Unverdi¹,

İnal

Çeri³

et al. 2013

Renal Failure

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Objective: Although colchicine is effective on prevention and regression of amyloidosis in many cases, rate of unresponsiveness to colchicine therapy is not too low. However, there is no sufficient data about which factors effect to response of colchicine therapy on regression of amyloidosis. Materials and methods: 24 patients with renal amyloidosis were enrolled into the study. The patients were divided in two groups according to urinary protein excretions: non-nephrotic stage (14/24) and nephrotic stage (10/24). The patients were also categorized according to the etiology of amyloidosis; familial Mediterranean fever (FMF)-associated amyloidosis (15/24) versus rheumatoid disorders (RD)-associated amyloidosis (9/24). The changes of amount of proteinuria and estimated glomerular filtration rates were investigated after colchicine treatment started in these groups. Results: The mean follow-up period was 27.7 AE 19.2 months. After initiating colchicine therapy, the degree of proteinuria was decreased higher than 50% in 11/14 (78%) of non-nephrotic patients and elevated only in three (22%) patients. In nephrotic group, proteinuria was increased in 5/10 (50%) of patients. Glomerular filtration rates were stable in nephrotic and non-nephrotic groups. Presenting with nephrotic syndrome was higher in RD-associated amyloidosis (RD_A) group (5/9) than FMF-associated amyloidosis (FMF_A) group (5/15) without statistical significance (p40.05). After colchicine treatment, proteinuria was decreased in 12/15 patients in FMF_A group, however, the significant decreasing of proteinuria was not observed in RD_A group (p ¼ 0.05 vs. p40.05). Conclusion: Colchicine therapy was found more effective in low proteinuric stage of amyloidosis. The beneficial effect of colchicine therapy was not observed in patients with RD-associated amyloidosis.

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Section: Discussionsupporting

confidence: 84%

Is colchicine therapy effective in all patients with secondary amyloidosis?

Unverdi¹,

İnal

Çeri³

et al. 2013

Renal Failure

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“…However, even with established amyloidosis some nephrotic patients may go into partial or even full remission after administration of colchicine, but the response is not predictable [18]. As compared to the first period, there was a slight decline in the second period (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) and it is expected that the number of renal amyloidosis will considerably decrease over the next years.…”

Section: Discussionmentioning

confidence: 99%

Native kidney biopsies in Armenian and Swiss children: high prevalence of amyloidosis in Yerevan and of IgA nephropathy in Zurich

et al. 2014

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The spectrum of pathology in native kidney biopsies varies considerably between different countries. Based on similar biopsy policy and joint workup, biopsy data of native kidneys of children in Yerevan (Armenia) and Zurich (Switzerland) were compared over a period of two decades (1993-2002 and 2003-2012). A total of 487 renal biopsies in Yerevan (EVN), n = 253; median age 11.2 years (range 0.8-18; 56 % males) and in Zurich (ZRH), n = 234; median age 8.7 years (range 0.1-18; 61 % males) were analyzed. Biopsies from EVN were locally analyzed by light microscopy (LM) and sent to ZRH for electron microscopy (EM) and immunohistochemistry. Biopsies from ZRH were evaluated by LM, EM, and immunofluorescence. The significant difference concerns the high frequency of amyloidosis in EVN (25.4 % in the first and 19.4 % in the second decade vs. 0 % in ZRH) and of IgA nephropathy in ZRH (30.2 % in the first and 26.1 % in the second decade vs. 8.1 in EVN). Certain forms of glomerulonephritis (membranoproliferative type I and membranous) and primary focal segmental glomerulosclerosis tended to be more frequent in EVN than in ZRH. Amyloid nephropathy due to familial Mediterranean fever is still highly frequent in Armenia with a slight decrease in the second decade. In Switzerland, the most common finding was IgA nephropathy.

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“…Livneh et al and Sarkissian et al [11,12] also reported on reversal of nephrotic syndrome in amyloidosis of FMF, suggesting that treatment with colchicine should be started as early as possible in the course of FMF and should be continued indefinitely at the highest possible dose. For the presented case, further follow-up and evaluation are needed for a possible favorable outcome with colchicine treatment in the future.…”

Section: Discussionmentioning

confidence: 99%

Renal amyloidosis in a child with sickle cell anemia

et al. 2006

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The kidney is frequently affected in patients with sickle cell syndrome, i.e., homozygous and heterozygous patients, with a consequently large spectrum of renal abnormalities that may range from minimal functional changes to chronic renal failure. Here, we present a 13-year-old boy with sickle cell anemia (SCA) (HbSS) who was referred to our unit with nephrotic syndrome. Renal biopsy revealed AA type amyloidosis on the basis of light microscopic findings, indicating Congo red staining and immunohistochemistry. He had neither a family history of familial Mediterranean fever (FMF) nor any complaint of recurrent abdominal pain, arthritis, and fever, but frequent painful vaso-occlusive crises. The patient was found to have no MEFV gene (Mediterranean feVer) mutations either. Painful episodic attacks might provoke recurrent acute inflammation, leading to repeated stimulation of acute phase responses and cause secondary amyloidosis. To our knowledge, this boy is the first case of SCA complicated by renal amyloidosis observed in childhood.

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Colchicine in the treatment of renal amyloidosis secondary to familial Mediterranean fever

Cited by 7 publications

References 3 publications

Is colchicine therapy effective in all patients with secondary amyloidosis?

Is colchicine therapy effective in all patients with secondary amyloidosis?

Native kidney biopsies in Armenian and Swiss children: high prevalence of amyloidosis in Yerevan and of IgA nephropathy in Zurich

Renal amyloidosis in a child with sickle cell anemia

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