Dialysis arthropathy: amyloid or iron?

Cary, N.; Sethi, D.; Ea, Brown; Erhardt, C. C.; Woodrow, David; Gower, P E

doi:10.1136/bmj.293.6559.1392

Cited by 41 publications

(3 citation statements)

References 7 publications

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“…Synovial iron deposition secondary to iron overload or recurrent haemarthrosis may also be an important factor in the pathogenesis of joint damage.3 36 Although there was no association between total iron stores, as measured by serum ferritin concentrations, and arthropathy, in one necropsy study a relation was noted between the amount of synovial iron, the number of infiltrating mononuclear cells, and the extent of joint damage. Caution is needed in interpreting these data as the iron and cellular infiltrate may simply be secondary to recurrent bleeding in a damaged joint.…”

Section: The Relation Between Increased Serum Ferritin Andmentioning

confidence: 99%

'Dialysis related arthropathy': a survey of 95 patients receiving chronic haemodialysis with special reference to beta 2 microglobulin related amyloidosis.

Hurst

Berg

Disney

et al. 1989

Annals of the Rheumatic Diseases

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Section: The Relation Between Increased Serum Ferritin Andmentioning

confidence: 99%

'Dialysis related arthropathy': a survey of 95 patients receiving chronic haemodialysis with special reference to beta 2 microglobulin related amyloidosis.

Hurst

Berg

Disney

et al. 1989

Annals of the Rheumatic Diseases

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“…The articular amyloid deposits in HD patients have in several studies using immunohistochemical methods been shown to be composed of f12 m [30,35,38,39]. Evidence for the presence of amyloid in the intevertebral discs or joints has to date been presented in a few cases only [30, 41,42] and the role of amyloid in destructive spondylarthropathy and other arthropathies has been questioned [30,43]. Evidence for the presence of amyloid in the intevertebral discs or joints has to date been presented in a few cases only [30, 41,42] and the role of amyloid in destructive spondylarthropathy and other arthropathies has been questioned [30,43].…”

Section: Arthropathymentioning

confidence: 99%

β 2-microglobulin amyloidosis

Maury

1990

Rheumatol Int

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A number of rheumatic disorders occur in patients on long-term hemodialysis treatment. In recent years a clinical syndrome comprising carpal tunnel syndrome, destructive arthropathy, and cystic bone lesions has been recognized in these patients. Congo-red staining and microscopy in polarized light reveal a high frequency of amyloid in the affected tissues. Amino acid sequence data of the isolated major amyloid fibril protein show its identity with beta 2-microglobulin. beta 2-microglobulin amyloid has a predilection for synovial tissues and bone, but visceral deposits may also occur indicating the systemic nature of the disease. The clinicopathological features, pathogenesis, and diagnosis of beta 2-microglobulin amyloidosis are reviewed, and the therapeutic and prophylactic measures discussed. The identification of beta 2-microglobulin as an amyloidogenic protein has in an important way contributed to the understanding of the mechanisms of amyloidogenesis in general and emphasized the complexity of amyloid disease and the diversity of proteins capable of forming congophilic fibrillar deposits in human tissues.

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“…Nachdem Assenat et al [1] Amyloidablagerungen als Hauptbestandteil der Ver/inderungen des Karpaltunnels beschrieben haben und das Amyloid von Gejyo et al 1985 [11] immunhistologisch dem flz-Mikroglobulin (~2 M) zugeordnet werden konnte, sind zahlreiche Fallbeschreibungen, aber auch Ergebnisse systematischer Untersuchungen zum Stoffwechsel von f12 M und seiner potentiellen Bedeutung ffir die Bildung und Ablagerung von f12 M assoziiertem (AB)-Amyloid in verschiedenen artikulfiren und periartikul/iren Geweben mitgeteilt worden [2][3][4][5][6][7][8][9]13]. Nachdem Assenat et al [1] Amyloidablagerungen als Hauptbestandteil der Ver/inderungen des Karpaltunnels beschrieben haben und das Amyloid von Gejyo et al 1985 [11] immunhistologisch dem flz-Mikroglobulin (~2 M) zugeordnet werden konnte, sind zahlreiche Fallbeschreibungen, aber auch Ergebnisse systematischer Untersuchungen zum Stoffwechsel von f12 M und seiner potentiellen Bedeutung ffir die Bildung und Ablagerung von f12 M assoziiertem (AB)-Amyloid in verschiedenen artikulfiren und periartikul/iren Geweben mitgeteilt worden [2][3][4][5][6][7][8][9]13].…”

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Serumspiegel und organablagerungen vonΒ 2-mikroglobulin bei dialysepatienten

et al. 1990

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In radioimmunological estimation of beta 2-microglobulin (beta 2m) significant higher serum values were found in 36 dialysis patients (44.4 +/- 20.3 mg/l) in comparison with healthy probands (1.5 +/- 0.2 mg/l). A significant relation to the duration of dialysis, diuresis, symptoms of the musculo-skeletal system, but not to radiologic changes or bone biopsy findings could be seen. Post mortem examinations carried out in 21 dialysis patients revealed AB-amyloid deposits in synovial tissue of different joints (particularly shoulder and hip joint) or intervertebral discs in eight patients (age 48 to 73 years, dialysis duration less than four years) without correlation to serum beta 2m level or radiographically suspect areas. In the tissue of cervical spine or intervertebral discs of two patients suffering from destructive spondylarthropathy no amyloid could be detected. These results suggest that AB-amyloid may occur in elderly patients early in the course of hemodialysis and may be asymptomatic in most cases.

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Dialysis arthropathy: amyloid or iron?

Cited by 41 publications

References 7 publications

'Dialysis related arthropathy': a survey of 95 patients receiving chronic haemodialysis with special reference to beta 2 microglobulin related amyloidosis.

'Dialysis related arthropathy': a survey of 95 patients receiving chronic haemodialysis with special reference to beta 2 microglobulin related amyloidosis.

β 2-microglobulin amyloidosis

Serumspiegel und organablagerungen vonΒ 2-mikroglobulin bei dialysepatienten

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