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Pattern of renal amyloidosis in Indian patients.
  1. K. S. Chugh,
  2. B. N. Datta,
  3. P. C. Singhal,
  4. S. K. Jain,
  5. V. Sakhuja,
  6. S. C. Dash

    Abstract

    Two hundred and thirty-three patients with renal amyloidosis were studied in an attempt to identify the incidence and pattern of the disease in northern India. The incidence of amyloidosis was 1.01% of 6431 post-mortems and 8.4% of 1980 renal biopsies from patients who presented with clinical evidence of glomerular disease. Two hundred and three patients (87.1%) had secondary amyloidosis, 22 (9.4%) had primary amyloid and 8 patients (3.5%) had amyloidosis associated with multiple myeloma. Tuberculosis of various organs was the commonest predisposing disease accounting for 59.1% of secondary amyloidosis, followed by chronic suppurative lung disease in 24.1%. Rheumatoid arthritis, chronic osteomyelitis and lepromatous leprosy were seen in a small percentage of patients (2 to 8%). Proteinuria of varying degree was present in all the 233 patients and 12.9% of them had a daily protein excretion of more than 10 g. Post-mortem examination of 65 patients with renal amyloidosis showed that 75.3% also had amyloid deposit in the spleen, 63% in the liver, and 50.8% in the adrenals. Clinical evidence of disappearance of proteinuria was observed in 3 patients with secondary amyloidosis; in 2 of them, the regression of amyloidosis was confirmed by serial renal biopsy performed 3 and 5 years after the initial diagnosis.

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