Fever associated with severe dialysis-related amyloidosis

CEN Case Reports
Toshiaki NakanoTakanari Kitazono

Abstract

Dialysis-related amyloidosis (DRA) is one of the most important complications in patients on long-term hemodialysis (HD). DRA often affects the osteoarticular system; however, little is known about the role of β2-microglobulin in the induction of fever in HD patients. We report a 64-year-old woman on long-term (24 years) HD who developed polyarthralgia and intermittent fever. Infectious diseases, connective tissue diseases, and malignant neoplasm were ruled out. Computed tomography and magnetic resonance imaging showed swelling of the soft tissues around bilateral shoulder and hip joints, suggestive of amyloid deposits. Gallium scintigraphy showed abnormal uptake in the vicinity of several large joints. It was presumed that the fever was related to the amyloid joint deposits, and the patient was treated with prednisolone and β2-microglobulin adsorption therapy. The treatment resulted in the resolution of fever, relief of arthralgia, and normalization of several inflammatory cytokines and C-reactive protein. The findings suggest that massive DRA could cause systemic inflammatory response in patients on long-term HD.

References

Jun 28, 1985·Biochemical and Biophysical Research Communications·F GejyoT Shirahama
Jan 1, 1994·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·A ArgilésJ G Demaille
Jun 26, 1998·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·G EhlerdingJ Floege
Jan 6, 1999·Artificial Organs·K TsuchidaT Kishimoto
Oct 18, 2005·Biochimica Et Biophysica Acta·Suguru Yamamoto, Fumitake Gejyo
Oct 7, 2011·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Yuichiro YamamotoSatoshi Umemura

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