Secondary Renal Amyloidosis due to Long-Standing Tubulointerstitial Nephritis in a Patient With Sjögren Syndrome

Ooms, Vanessa; Decupere, Marc; Lerut, Evelyne; Vanrenterghem, Yves

doi:10.1053/j.ajkd.2005.07.019

Cited by 19 publications

(18 citation statements)

References 15 publications

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“…Moreover, glomerular disease, such as cryoglobulinemic membrano-proliferative glomerulonephritis, focal segmental glomerulosclerosis (FSGS), mesangial proliferative glomerulonephritis, membranous nephropathy and minimal change disease have been reported [2,6,7,24]. A single case of long-lasting TIN in a patient with PSS led to a secondary (AA) amyloidosis with, consequently, renal failure and nephrotic syndrome [18]. Interestingly, in one study SSA/Ro, SSB/La and rheumatoid factor, as well as hypergammaglobulinemia, were detected in all subjects with biopsy-proven renal involvement [6].…”

Section: Reviewmentioning

confidence: 99%

“…Primary Sjögren syndrome (PSS) is an autoimmune disorder of hitherto unknown origin which is characterized by polyclonal B-cell activation as well as lymphocytic infiltration of the exocrine glands, resulting in keratoconjunctivitis sicca (dry eyes disease) and/or xerostomia (dry mouth disease) [18]. In addition, extraglandular manifestations of PSS can affect organ systems, such as the lungs, blood vessels, skin, the gastrointestinal tract, central and peripheral nervous system, muscular skeletal apparatus and the kidney [19,20].…”

Section: Introductionmentioning

confidence: 99%

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Renal involvement in autoimmune connective tissue diseases

Kronbichler

Mayer

2013

BMC Med

107

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Connective tissue diseases (CTDs) are a heterogeneous group of disorders that share certain clinical presentations and a disturbed immunoregulation, leading to autoantibody production. Subclinical or overt renal manifestations are frequently observed and complicate the clinical course of CTDs. Alterations of kidney function in Sjögren syndrome, systemic scleroderma (SSc), auto-immune myopathies (dermatomyositis and polymyositis), systemic lupus erythematosus (SLE), antiphospholipid syndrome nephropathy (APSN) as well as rheumatoid arthritis (RA) are frequently present and physicians should be aware of that.In SLE, renal prognosis significantly improved based on specific classification and treatment strategies adjusted to kidney biopsy findings. Patients with scleroderma renal crisis (SRC), which is usually characterized by severe hypertension, progressive decline of renal function and thrombotic microangiopathy, show a significant benefit of early angiotensin-converting-enzyme (ACE) inhibitor use in particular and strict blood pressure control in general. Treatment of the underlying autoimmune disorder or discontinuation of specific therapeutic agents improves kidney function in most patients with Sjögren syndrome, auto-immune myopathies, APSN and RA.In this review we focus on impairment of renal function in relation to underlying disease or adverse drug effects and implications on treatment decisions.

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Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Renal involvement in autoimmune connective tissue diseases

Kronbichler

Mayer

2013

BMC Med

107

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“…Although it is very rare, systemic amyloidosis has been observed in patients with SS; systemic AA amyloidosis may occur because of longstanding inflammation (6), and systemic AL amyloidosis may occur because of the development of an immunoglobulin light chain–producing lymphoproliferative disease (7). Systemic AL amyloidosis itself can affect the lacrimal and salivary glands and is therefore one of the causes of sicca syndrome (7).…”

mentioning

confidence: 99%

Sjögren's syndrome and localized nodular cutaneous amyloidosis: Coincidence or a distinct clinical entity?

Meijer¹,

Schönland²,

Palladini³

et al. 2008

Arthritis & Rheumatism

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Objective. To report 8 patients with Sjögren's syndrome (SS) and localized nodular cutaneous amyloidosis and to examine serologic and immunohistologic findings that may link the 2 diseases.Methods. The databases for 3 amyloidosis centers were searched for patients with localized nodular cutaneous amyloidosis and SS. Eight patients with this combination were identified, and clinical, serologic, and histologic parameters were retrospectively evaluated.Results. Among the 8 patients with a clinical diagnosis of SS, 6 fulfilled the American-European Consensus Group criteria for SS. All of the patients were women in whom SS had been diagnosed at a median age of 47 years (range 30-61 years) and amyloid had been diagnosed at a median age of 60 years (range 42-79 years). The presence of the immunoglobulin light chain type of amyloid (AL amyloid) was confirmed in 4 patients. In 3 of these 4 patients as well as 2 other patients, a light chain-restricted plasma cell population was observed near the amyloid deposits. Progression to systemic amyloidosis was not observed in any patient during a median followup of 3.5 years.

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“…Systemic amyloidosis presenting as a sicca syndrome has been reported in six cases [61][62][63][64][65][66]. However, systemic amyloidosis has been reported to coexist with SS in two patients (the first was an AA amyloidosis diagnosed in a patient with long-standing tubulo-interstitial nephritis and the second was an AL amyloidosis [67,68]). …”

Section: Amyloidosismentioning

confidence: 97%

Lessons From Diseases Mimicking Sjögren’s Syndrome

Ramos-Casals

Brito-Zerón

Font

2007

Clinic Rev Allerg Immunol

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Sjögren's syndrome (SS) is a systemic autoimmune disease that mainly affects the exocrine glands and usually presents as persistent dryness of the mouth and eyes because of functional impairment of the salivary and lacrimal glands. The histological hallmark is a focal lymphocytic infiltration of the exocrine glands, and the spectrum of the disease extends from an organ-specific autoimmune disease (autoimmune exocrinopathy) to a systemic process with diverse extraglandular manifestations. In the absence of an associated systemic autoimmune disease, patients with this condition are classified as having primary SS. The differential diagnosis includes processes that specifically involve the exocrine glands. On the one hand, some chronic viral infections may induce lymphocytic infiltration of the exocrine glands, in some cases indistinguishable from that observed in primary SS. On the other hand, some processes may mimic the clinical picture of SS through nonlymphocytic infiltration of the exocrine glands. This review focuses on these two groups of diseases that mimic SS (infections and infiltrating processes).

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Secondary Renal Amyloidosis due to Long-Standing Tubulointerstitial Nephritis in a Patient With Sjögren Syndrome

Cited by 19 publications

References 15 publications

Renal involvement in autoimmune connective tissue diseases

Renal involvement in autoimmune connective tissue diseases

Sjögren's syndrome and localized nodular cutaneous amyloidosis: Coincidence or a distinct clinical entity?

Lessons From Diseases Mimicking Sjögren’s Syndrome

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