Control of <scp>AA</scp> amyloidosis complicating Crohn's disease: a clinico‐pathological study

Denis, Marie Armelle; Cosyns, Jean‐Pierre; Persu, Alexandre; Dewit, Olivier; Galocsy, Chantal de; Hoang, Pierre; Maldague, P; Wallemacq, Pierre; Zerbib, Frank; Fiasse, René

doi:10.1111/eci.12045

Cited by 15 publications

(17 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Electron microscopy is a useful tool to corroborate the amyloid and exclude another type of deposit, and immunohistochemistry helps to determine the type of amyloid protein. 2 Denis et al reported that amyloid deposition tends to involve all kidney compartments, which may play a role in the development of interstitial fibrosis and tubular atrophy leading to kidney failure 8 ; this histologic pattern was seen in our patient ( Figure 2 ).…”

Section: Discussionsupporting

confidence: 62%

“…4 Some other locations of amyloid deposition include the heart, thyroid, duodenum, colon, rectum, adrenal glands, pancreas, spleen, and bone marrow, although frequency in these locations is lower compared to kidney compromise. [7][8][9][10] The gold standard for diagnosis is the presence of amyloid deposition in histologic specimens, although a negative result does not exclude the presence of amyloidosis, as deposits may be patchy. 2 The presence of apple green birefringence under cross-polarized light in a tissue biopsy stained with Congo red is diagnostic of amyloidosis, 2 as observed in our case (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Because of the low prevalence of sys-temic amyloidosis in IBD, most data come from descriptive studies (principally case series) that either pooled patients with IBD 6,7,11,[14][15][16][17] or reported amyloidosis in patients with CD. [8][9][10]18 Therapeutic studies are lacking because of the rarity of systemic amyloidosis in IBD, and treatment is based on observational studies, expert recommendations, and extrapolation from the rheumatic diseases literature. 4 Most of the experience from observational studies was pooled by Tosca Cuquerella et al 4 The primary objective is to control systemic inflammation leading to amyloid deposition.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Renal Amyloidosis and Crohn Disease

Barahona-Correa

Morales

Andrade-Pérez

et al. 2021

TOJ

View full text Add to dashboard Cite

Background: Secondary amyloidosis, a rare complication of Crohn disease (CD), is triggered by persistent systemic inflammation. Kidney involvement is the most frequent manifestation and is often characterized by nephrotic syndrome and kidney failure. This complication usually appears in patients with long-standing disease and is associated with increased morbidity and mortality risk. Diagnosis is by microscopic amyloid observation of tissue biopsy, and when the diagnosis is confirmed, the therapeutic objective is disease activity control. Response assessment is challenging because of a lack of reliable biomarkers. Case Report: A 56-year-old male with a long-standing history of CD treated with a tumor necrosis factor-α inhibitor presented with an acute elevation of creatinine in association with clinical and laboratory markers of nephrotic syndrome. Kidney biopsy revealed renal amyloidosis. After treatment adjustment, although a stable creatinine was achieved, the patient had persistent impaired glomerular filtration rate. Conclusion: As a systemic chronic inflammatory disorder, CD may present multisystemic morbidity, for which increased awareness among gastroenterologists is warranted. Renal amyloidosis is an infrequent extraintestinal complication of CD that may lead to chronic kidney impairment. Although evidence-based treatment is lacking, disease activity control is pivotal for management.

show abstract

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Renal Amyloidosis and Crohn Disease

Barahona-Correa

Morales

Andrade-Pérez

et al. 2021

TOJ

View full text Add to dashboard Cite

show abstract

“…Treating the underlying inflammatory disease with anti-inflammatory drugs (Table 1) lowers the concentration of SAA and its amyloidogenic fragments (Fig. 3C), ameliorating renal dysfunction, providing strong evidence that SAA fragment aggregation causes AA amyloidosis 107-112 .…”

Section: Strategies To Target the Process Of Protein Aggregationmentioning

confidence: 87%

Targeting protein aggregation for the treatment of degenerative diseases

Eisele

Monteiro

Fearns

et al. 2015

Nat Rev Drug Discov

357

333

View full text Add to dashboard Cite

The aggregation of specific proteins is hypothesized to underlie several degenerative diseases, collectively called amyloid disorders. However, the mechanistic connection between the process of protein aggregation and tissue degeneration is not yet fully understood. Here, we review current and emerging strategies to ameliorate aggregation-associated degenerative disorders, with a focus on disease-modifying strategies that prevent the formation of and/or eliminate protein aggregates. Persuasive pharmacologic and genetic evidence now support protein aggregation as the cause of post-mitotic tissue dysfunction or loss. However, a more detailed understanding of the factors that trigger and sustain aggregate formation, as well as the structure-activity relationships underlying proteotoxicity are needed to develop future disease-modifying therapies.

show abstract

“…Patients present with asymptomatic hepatomegaly and rarely the diagnosis of hepatic amyloidosis precedes that of IBD [146]. Suppression of gut inflammation in Crohn's disease reduces the oxidative burden thereby reducing precursors of amyloid fibrils and progression of hepatic amyloidosis [147,148]. Though medical management has limited success; colchicine, budesonide and infliximab been tried with varied results [149-151].…”

Section: Secondary Amyloidosismentioning

confidence: 99%

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

View full text Add to dashboard Cite

Disorders of the liver and the biliary tract are frequently the extraintestinal manifestations of inflammatory bowel disease (IBD). The etiology of these hepato-biliary conditions is deemed secondary to their shared pathogenesis, the chronic effects of a long term, ongoing inflammation of the bowels, along with the medications used to manage IBD. For up to 30% of patients with IBD, abnormal liver biochemical tests are present. Other, selected patients with IBD are followed for reactivation of hepatitis B, through guidelines only relatively recently in place. The vast realm of related clinical conditions does not always correspond well with IBD severity, which can range from mild hepatic insult to end-stage liver disease, necessitating liver transplantation. Hence it is critical to follow its presence, clinical course and long term consequences. Moreover, the management of these disorders is necessarily individualized, with some patients requiring frequent monitoring and others a more multi-disciplinary approach. Studies aimed at improving the outcomes of patients with IBD who experience associated liver and biliary tract disorders are now needed to assess early identification, possible screening approaches and more effective systems of referral. This article covers the evidence-based literature on topics detailing the co-existence of liver conditions in inflammatory bowel disease with a focus on its epidemiology, clinical manifestations, diagnosis and management.

show abstract

Control of AA amyloidosis complicating Crohn's disease: a clinico‐pathological study

Abstract: Suppression of Crohn's disease inflammation potentially leads to the control of amyloid A production, assessed by a decrease of serum amyloid A. Kidney transplantation provides a long survival.

Cited by 15 publications

References 29 publications

Renal Amyloidosis and Crohn Disease

Renal Amyloidosis and Crohn Disease

Targeting protein aggregation for the treatment of degenerative diseases

A review of liver disorders in inflammatory bowel disease (IBD)

Contact Info

Product

Resources

About