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Fever associated with severe dialysis-related amyloidosis
#MMPMID28509071
Nakano T
; Nagae H
; Murakami N
; Taniguchi M
; Ikeda H
; Matsuo D
; Tsuruya K
; Kitazono T
CEN Case Rep
2012[Nov]; 1
(2
): 112-116
PMID28509071
show ga
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 ?(2)-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 ?(2)-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.
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