Remission of nephrotic syndrome after removal of localized castleman's disease

Keven, Kenan; Nergızoğlu, Gökhan; Ateş, Kenan; Erekul, Selim; Orhan, Dıclehan; Ertürk, Şehsuvar; Tulunay, Özden; Karatan, Oktay; Ertug, A. E.

doi:10.1016/s0272-6386(00)70059-x

Cited by 32 publications

(16 citation statements)

References 21 publications

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“…Whereas Keven et al [23]found no sign of histological regression of amyloid, we were able to observe at electron microscopy the onset of GBM repair process. It has been demonstrated that amyloid deposits can disappear after CD cure in abdominal fat [2]or in the rectum [17].…”

Section: Discussioncontrasting

confidence: 85%

“…Surgical excision of the mass [2, 14, 17, 19, 23]or chemotherapy [15, 22]sometimes resolves both the systemic symptoms and the nephrotic syndrome. However, in some cases where the renal damage due to the amyloidosis was more advanced, patients have had to remain on dialysis, despite complete surgical cure of their CD [18, 20, 21].…”

Section: Discussionmentioning

confidence: 99%

“…Various lesions have been described, ranging from all kinds of glomerulonephritis (minimal change [5], membranous [6, 7], mesangial [4], membranoproliferative [8, 9], crescentic [10, 11], fibrillar [12]) to amyloidosis [2, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23]. Renal amyloidosis has hitherto been reported in only 11 CD patients in whom a renal biopsy was done.…”

Section: Introductionmentioning

confidence: 99%

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Remission of Nephrotic Syndrome due to AA Amyloidosis and Initiation of Glomerular Repair after Surgical Resection of Localized Castleman’s Disease

Mandreoli

Casanova

Vianelli

et al. 2002

Nephron

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To shed further light on the eventual destiny of amyloid kidney deposits after interruption of amylogenic stimulus, we report a case of a 47-year-old woman with nephrotic syndrome due to renal amyloidosis, complicating abdominal Castleman’s disease. After 5 courses of therapy with melphalan and prednisolone which failed to improve the nephrotic syndrome or her general clinical condition, and 1 year after the diagnosis of renal amyloidosis, surgical excision of the abdominal mass was performed. Whereas her clinical symptoms and other laboratory findings rapidly improved, the proteinuria took 18 months to disappear. A second renal biopsy, performed 30 months after surgical resection, showed persistence of the amyloid deposits in the same extent. However, electron microscopy revealed subtle reparative phenomena at the epithelial site of the basement membrane. We conclude that proteinuria associated with amyloidosis does not only depend on structural damage and that the new synthesized segment of basement membrane observed by us probably represents a mechanism of repair and the start of a long healing process.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Remission of Nephrotic Syndrome due to AA Amyloidosis and Initiation of Glomerular Repair after Surgical Resection of Localized Castleman’s Disease

Mandreoli

Casanova

Vianelli

et al. 2002

Nephron

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“…We could not have control biopsies proving regression of amyloid deposits after colchicine treatment. However, Keven et al reported that the regression of amyloid deposits by renal biopsy was not revealed in a case of mixed type of localized Castleman's disease complicated with AA amyloidosis, despite complete remission of nephrotic syndrome (15).…”

Section: Discussionmentioning

confidence: 99%

Complete remission of nephrotic syndrome in secondary amyloidosis of familial Mediterranean fever following colchicine treatment Ailevi Akdeniz ateşi ve sekonder amiloidozise bağlı nefrotik sendromun

Düzgün¹

2005

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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A 25-year-old woman of Turkish origin with an 18 year long history of familial Mediterranean fever (FMF) attacks characterized with fever, arthritis and abdominal pain developed symptoms of the nephrotic syndrome in 1999. The renal biopsy revealed small amounts of amyloid deposits. Intestinal mucosa (rectum) also showed amyloid infiltration. The patient was homozygous for M694V mutation. She has responded to colchicine with a resolution of clinical signs and nephrotic range proteinuria. Similar cases have been rarely described. In this case, an 18-year delayed diagnosis and treatment of FMF, reversible nephrotic stage of amyloidotic renal disease by colchicine and a favorable course were discussed .

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“…The presence of a close relationship between elevated IL-6 and the deposition of serum amyloid A protein in the form of amyloid suggests that IL-6, as a major regulator of the acute phase response, is likely to play an important role in the pathogenesis of amyloid deposition in CD. Somereports emphasize this due to the complete remission of nephrotic syndrome by AAamyloidosis after removal of the lymphoid mass of CD (9,10). In this issue of Internal Medicine, Wuet al (ll) reported a case of acute interstitial nephritis with plasma cell and B cell infiltration in probable MCD.…”

mentioning

confidence: 99%