P378 Renal AA amyloidosis associated with Crohn's disease

Bibani, N; Gharbi, O.; Trad, D; Sabbah, M; Ouakaa, A; Gargouri, Dalila; Elloumi, Héla; Kharrat, Jamel

doi:10.1093/ecco-jcc/jjx002.503

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“…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%

Renal Amyloidosis and Crohn Disease

Barahona-Correa

Morales

Andrade-Pérez

et al. 2021

TOJ

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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.

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