Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literature
Background: Systemic AA amyloidosis is a long-term complication of several chronic inflammatory disorders. Organ damage results from the extracellular deposition of proteolytic fragments of the acute-phase reactant serum amyloid A (SAA) as amyloid fibrils. Drug users that inject drug by a subcutaneo...
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| Format: | Article |
| Language: | English |
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Society of Diabetic Nephropathy Prevention
2013-07-01
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| Series: | Journal of Nephropathology |
| Subjects: | |
| Online Access: | https://nephropathol.com/PDF/jnp-2-201.pdf |
| _version_ | 1797827919297380352 |
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| author | Ali Momeni Hamid Nasri |
| author_facet | Ali Momeni Hamid Nasri |
| author_sort | Ali Momeni |
| collection | DOAJ |
| description | Background: Systemic AA amyloidosis is a long-term complication of several chronic inflammatory disorders. Organ damage results from the extracellular deposition of proteolytic fragments of the acute-phase reactant serum amyloid A (SAA) as amyloid fibrils. Drug users that inject drug by a subcutaneous route ("skin popping") have a higher chance of developing secondary amyloidosis. The kidneys, liver, and spleen are the main target organs of AA amyloid deposits. More than 90% of patients with renal amyloidosis will present with proteinuria, nephrotic syndrome, or renal dysfunction. Case presentation: A 37 year-old female presented to the hospital with a one-week history of pain and redness in her right axilla. Her relevant medical history included multiple skin abscesses secondary to "skin popping", heroin abuse for 18 years, and hepatitis C. The physical examination revealed "skin popping" lesions, bilateral costovertebral angle tenderness, and bilateral knee swelling. The laboratory workup was significant for renal insufficiency with a serum creatinine of 5 mg/dL and 14.8 grams of urine protein per 1 gram of urine creatinine. The renal biopsy findings were consistent with a diagnosis of renal amyloidosis due to serum amyloid A deposition and acute tubulointerstitial nephritis. Conclusions: AA renal amyloidosis among heroin addicts seems to be associated with chronic suppurative skin infection secondary to "skin popping". It is postulated that the chronic immunologic stimulation by one or more exogenous antigens or multiple acute inflammatory episodes is an important factor in the pathogenesis of amyloidosis in these patients. Therefore, AA renal amyloidosis should always be considered in chronic heroin users presenting with proteinuria and renal impairment. |
| first_indexed | 2024-04-09T12:56:07Z |
| format | Article |
| id | doaj.art-856b8e62baf8443882c563b4dd8e5909 |
| institution | Directory Open Access Journal |
| issn | 2251-8363 2251-8819 |
| language | English |
| last_indexed | 2024-04-09T12:56:07Z |
| publishDate | 2013-07-01 |
| publisher | Society of Diabetic Nephropathy Prevention |
| record_format | Article |
| series | Journal of Nephropathology |
| spelling | doaj.art-856b8e62baf8443882c563b4dd8e59092023-05-13T11:43:00ZengSociety of Diabetic Nephropathy PreventionJournal of Nephropathology2251-83632251-88192013-07-012320120310.12860/JNP.2013.32JNP_20130930163504Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literatureAli Momeni0Hamid Nasri1Department of Nephrology, Shahrekord University of Medical Sciences, Shahrekord, IranDepartment of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences,Isfahan, IranBackground: Systemic AA amyloidosis is a long-term complication of several chronic inflammatory disorders. Organ damage results from the extracellular deposition of proteolytic fragments of the acute-phase reactant serum amyloid A (SAA) as amyloid fibrils. Drug users that inject drug by a subcutaneous route ("skin popping") have a higher chance of developing secondary amyloidosis. The kidneys, liver, and spleen are the main target organs of AA amyloid deposits. More than 90% of patients with renal amyloidosis will present with proteinuria, nephrotic syndrome, or renal dysfunction. Case presentation: A 37 year-old female presented to the hospital with a one-week history of pain and redness in her right axilla. Her relevant medical history included multiple skin abscesses secondary to "skin popping", heroin abuse for 18 years, and hepatitis C. The physical examination revealed "skin popping" lesions, bilateral costovertebral angle tenderness, and bilateral knee swelling. The laboratory workup was significant for renal insufficiency with a serum creatinine of 5 mg/dL and 14.8 grams of urine protein per 1 gram of urine creatinine. The renal biopsy findings were consistent with a diagnosis of renal amyloidosis due to serum amyloid A deposition and acute tubulointerstitial nephritis. Conclusions: AA renal amyloidosis among heroin addicts seems to be associated with chronic suppurative skin infection secondary to "skin popping". It is postulated that the chronic immunologic stimulation by one or more exogenous antigens or multiple acute inflammatory episodes is an important factor in the pathogenesis of amyloidosis in these patients. Therefore, AA renal amyloidosis should always be considered in chronic heroin users presenting with proteinuria and renal impairment.https://nephropathol.com/PDF/jnp-2-201.pdfc1q nephropathydiabetic nephropathyglomerulopathy |
| spellingShingle | Ali Momeni Hamid Nasri Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literature Journal of Nephropathology c1q nephropathy diabetic nephropathy glomerulopathy |
| title | Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literature |
| title_full | Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literature |
| title_fullStr | Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literature |
| title_full_unstemmed | Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literature |
| title_short | Concurrent diabetic nephropathy and C1q nephropathy in a young male patient: The first report in literature |
| title_sort | concurrent diabetic nephropathy and c1q nephropathy in a young male patient the first report in literature |
| topic | c1q nephropathy diabetic nephropathy glomerulopathy |
| url | https://nephropathol.com/PDF/jnp-2-201.pdf |
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