Pattern of renal amyloidosis in Indian patients

Abstract

SummaryTwo hundred and thirty-three patients with renal amyloidosis were studied in an attempt to identify the incidence and pattern of the disease in northern India. The incidence of amyloidosis was 1 01% of 6431 postmortems and 8-4 % of 1980 renal biopsies from patients who presented with clinical evidence of glomerular disease. Two hundred and three patients (87 1 %) had secondary amyloidosis, 22 (9-4 %) had primary amyloid and 8 patients (3 5 %) had amyloidosis associated with multiple myeloma. Tuberculosis of various organs was the commonest predisposing disease accounting for 59 1% of secondary amyloidosis, followed by chronic suppurative lung disease in 241 %. Rheumatoid arthritis, chronic osteomyelitis and lepromatous leprosy were seen in a small percentage of patients (2 to 8 %). Proteinuria of varying degree was present in all the 233 patients and 12-9 % of them had a daily protein excretion of more than 10 g.Post-mortem examination of 65 patients with renal amyloidosis showed that 75-3 % also had amyloid deposit in the spleen, 63 % in the liver, and 50 8 % in the adrenals.

Spectrum of glomerular diseases - clinico-pathologic observations from a state run tertiary care centre

“…This is comparable to that reported by recent studies; 11,25 but much lower compared to older Indian studies(8.4%), of which the major subclass was secondary (59.1%). 26 This could be attributed to lowered prevalence of tuberculosis and other chronic infections in the present era. We also noted a high incidence of PIGN (5.69% of all biopsies) which evolve to rapidly progressive RF (10.71% of all PIGNs), comparable to other studies from developing countries.…”

Renal Tuberculosis in the Modern Era

“…Chronic TB can complicate with amyloidosis and is an important cause of chronic kidney disease in India, 26 and probable underdiagnosis in many countries. There are several cases of TB associated with different forms of glomerulonephritis, but there is no proven relationship with TB as the primary cause.…”

Leukocyte Cell–Derived Chemotaxin 2–Associated Amyloidosis

“…Amyloidosis can be systemic or localized. In the United States and Europe, Ig light chain-derived (AL) amyloidosis is, by far, the most frequent type, whereas in developing countries, AA amyloidosis is more common than AL amyloidosis (2). Kidney involvement is present in most patients with AL amyloidosis (3) and AA amyloidosis (4) and may also occur in several rare hereditary forms of amyloidosis, such as those derived from fibrinogen A, transthyretin (ATTR), gelsolin (particularly in homozygotes), lysozyme, apo AI (AApo AI), AApo AII, and AApo AIV (5)(6)(7)(8).…”