Secondary renal amyloidosis associated with asbestos-related pleuropulmonary diseases.

CEN Case Reports
Ryoko ShibataHitoshi Nakashima

Abstract

Here, we present a 67-year-old Japanese man who developed insidious-onset nephrotic syndrome. He had a history of occupational asbestos exposure for about 8 years during his 30s, and was found to have pleural effusion 3 years before his present illness. At that time, repeated cytology testing of his pleural effusion found no malignant cells, and pleural biopsy found fibrous pleuritis without evidence of malignant mesothelioma. Percutaneous kidney biopsy found massive deposits of AA-type amyloid in the glomeruli, small arteries, and medulla. Computed tomography showed a calcified mass in the right lower lung that was positive for 67Ga uptake, but transbronchial lung biopsy and bronchoalveolar lavage found no evidence of malignancy. He was diagnosed with rounded atelectasis and diffuse pleural thickening. As these benign asbestos-related diseases have no standard treatment, we administered low-dose angiotensin II receptor blocker to preserve kidney function. Unfortunately, his nephrotic syndrome persists, with progressive chronic kidney failure. Kidney involvement in patients with asbestos-related disease is rare. To our knowledge, this is the first case to present with secondary amyloidosis. Kidney biopsy should be considered fo...Continue Reading

References

Dec 1, 1994·American Journal of Respiratory and Critical Care Medicine·M R Becklake, B W Case
Jan 1, 1994·Nephron·S TanakaT Kaneko
Apr 26, 2001·Postgraduate Medical Journal·C K Farmer, D J Goldsmith
Feb 5, 2014·Internal Medicine·Seiichiro SuzukiTakafumi Suda
Aug 30, 2014·Respiration; International Review of Thoracic Diseases·Nobukazu FujimotoTakumi Kishimoto
Dec 23, 2015·Pulmonary Medicine·Nobukazu FujimotoTakumi Kishimoto
Feb 6, 2017·Journal of Thoracic Disease·Toru NakanoNoriaki Ohuchi
Jan 8, 2018·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Eduardo Solbes, Richart W Harper

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