Rapidly progressive glomerulonephritis associated with amyloidosis: Efficacy of plasma exchange

Vernier, I; Pourrat, Jacques; Mignon-Conte, M; Hemery, M.-L.; Dueymes, J M; Conté, J

doi:10.1002/jca.2920030407

Cited by 15 publications

(8 citation statements)

References 8 publications

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“…Kidney samples of renal amyloidosis have been known to contain glomerular crescents, a typical pathology of rapidly progressive glomerulonephritis. There have been only few reported cases where renal histology supports the coexistence of the two renal diseases 6–11 . Since crescents are a non‐specific glomerular pathology varying in incidence, sampling of biopsy material may affect the incidence of association of crescents in amyloidosis.…”

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confidence: 99%

Glomerular crescents in renal amyloidosis: An epiphenomenon or distinct pathology?

Nagata¹,

Shimokama

Harada

et al. 2001

Pathology International

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There have been several reports of cases of renal amyloidosis with glomerular crescents. However, it is not clear whether the association is fortuitous or pathogenic related. The present study analyzed 105 cases of renal amyloidosis (61 autopsy cases and 44 biopsy cases) and found glomerular crescents in 14 (13.3%) cases. Among the 14 cases with crescents, a female predominance was noted (male: female, 3: 11) and rheumatoid arthritis was the most common primary disease of amyloidosis. Immunohistochemical analysis demonstrated amyloid protein of AA type in 12 cases. According to the histologic classification, there were 11 cases of mesangial nodular type, which was almost exclusively accompanied by AA amyloid deposition. Of note, the incidence of crescents neither correlated with the extent of amyloid deposition nor the presence of nephrotic syndrome. By contrast, localization of amyloid deposition was closely related to crescent formation. Moreover, electron microscopic observation displayed rupture of the glomerular basement membrane at the site of amyloid deposition. Our results indicated that glomerular crescents were more frequently associated with renal amyloidosis than previously appreciated. Rupture of the fragile glomerular basement membrane by amyloid deposition, as revealed by immunostaining and electron microscopy, may be the mechanism of crescent formation. We suggest that glomerular crescents are a distinct pathology associated with renal amyloidosis, not fortuitous conditions.

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confidence: 99%

Glomerular crescents in renal amyloidosis: An epiphenomenon or distinct pathology?

Nagata¹,

Shimokama

Harada

et al. 2001

Pathology International

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“…These are virtually exclusively cases of AA amyloidosis that also feature glomerular extracapillary proliferation, a hallmark of crescentic glomerulonephritis [10], mostly in patients with florid rheumatoid arthritis [11, 12, 13, 14, 15, 16]. In these cases, the mechanism of glomerular injury is thought to involve basement membrane rupture and mesangial cell dysfunction due to amyloid-fibril deposition, leading to leakage of proteinaceous material and cellular contents into Bowman’s space, thereby initiating glomerular crescent formation [13].…”

Section: Discussionmentioning

confidence: 99%

Atypical case of AL amyloidosis with urinary erythrocyte casts

Liangos

Buettner-Herold

Ketteler

et al. 2015

CNCS

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We present the case of a 73-year-old man who developed an acute, severe febrile illness with multiorgan dysfunction, featuring renal failure, nephrotic-range proteinuria, microhematuria, and a skin rash. Numerous erythrocyte casts were found on urine microscopy. Typically, the finding of urinary erythrocyte casts indicates the presence of an underlying glomerular inflammatory disease. However, on renal biopsy, only amyloid light-chain (AL) amyloidosis and tubular injury were the predominant findings with no signs of glomerular or vascular inflammation. Photomicrographs of urinary sediment as well as renal biopsy histopathology of the presented case are shown. The unusual combination of findings, is then discussed in light of the existing literature on renal amyloidosis as well as erythrocyte casts in conditions other than glomerulonephritis.

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“…The renal function remained stable at 2 years, although heavy proteinuria persisted. [15] Moroni et al ., in their report of three cases of crescentic glomerulonephritis superimposed on amyloidosis, have documented partial recovery of renal functions in two patients after treatment with intravenous pulse methylprednisolone, immunosuppressive agents, and oral corticosteroids. [16]…”

Section: Discussionmentioning

confidence: 99%

Rapidly progressive glomerulonephritis in a patient with renal amyloidosis: Case report and review of the literature

Anupama¹,

Vankalakunti²

2012

Indian J Nephrol

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Renal amyloidosis is characterized by progressive deposition of extracellular material, most commonly in the glomeruli. Most often, patients present with nephrotic range proteinuria and the disease progresses gradually to renal failure. Rapid worsening of renal functions is rare. We report a case of crescentic glomerulonephritis superimposed on amyloidosis, clinically presenting as rapidly progressive renal failure, and present a review of the literature.

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Rapidly progressive glomerulonephritis associated with amyloidosis: Efficacy of plasma exchange

Cited by 15 publications

References 8 publications

Glomerular crescents in renal amyloidosis: An epiphenomenon or distinct pathology?

Glomerular crescents in renal amyloidosis: An epiphenomenon or distinct pathology?

Atypical case of AL amyloidosis with urinary erythrocyte casts

Rapidly progressive glomerulonephritis in a patient with renal amyloidosis: Case report and review of the literature

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