Synovial amyloidosis in patients undergoing long-term hemodialysis

✍ Scribed by Thomas Bardin; Daniel Kuntz; Johanna Zingraff; Marie-Catherine Voisin; Alain Zelmar; Juliette Lansaman

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 821 KB
• Volume: 28
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780280913

✦ Synopsis

Synovial amyloid deposits were found in 18 patients with end-stage renal failure due to various nonamyloid nephropathies, who had been treated with longterm, periodic hernodialysis (mean 116 months). All patients had carpal tunnel syndrome, which was bilateral in 14 of them; 4 patients also had finger flexor tenosynovitis. In 2 patients, destructive arthropathies required surgical replacement of the hip. Amyloid deposits were demonstrated by light microscopy in the synovium of the finger flexor tendon andlor transverse carpal ligament of all patients who had surgery for carpal tunnel syndrome, and in the synovium and capsula of the 2 surgically removed hips. Transmission electron microscopy of synovial samples from 6 patients demonstrated the characteristic fibrillar ultrastructure of amyloid deposits, the biochemical nature of which is still unknown. In addition, 9 patients had cystic radiolucencies of bone, which were interpreted as having resulted from local amyloid deposits, involving carpal bones, humeral heads, femoral heads, acetabula, or tibia1 plateaus. Our results show that amyloidosis is a

From the Clinique de Rhumatologie, Centre Viggo Petersen, and the