Renal amyloidosis and crohn disease
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Fecha
2021-09Autor(es) Corporativo(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Medicina Interna
Pontificia Universidad Javeriana. Facultad de Medicina. Hospital Universitario San Ignacio
Tipo
Artículo de revista
ISSN
1524-5012
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Abstract
Background: Secondary amyloidosis, a rare complication of Crohn disease (CD), is triggered by persistent systemic inflammation.
Kidney involvement is the most frequent manifestation and is often characterized by nephrotic syndrome and kidney failure. This
complication usually appears in patients with long-standing disease and is associated with increased morbidity and mortality risk.
Diagnosis is by microscopic amyloid observation of tissue biopsy, and when the diagnosis is confirmed, the therapeutic objective
is disease activity control. Response assessment is challenging because of a lack of reliable biomarkers.
Case Report: A 56-year-old male with a long-standing history of CD treated with a tumor necrosis factor-α inhibitor presented with
an acute elevation of creatinine in association with clinical and laboratory markers of nephrotic syndrome. Kidney biopsy revealed
renal amyloidosis. After treatment adjustment, although a stable creatinine was achieved, the patient had persistent impaired
glomerular filtration rate.
Conclusion: As a systemic chronic inflammatory disorder, CD may present multisystemic morbidity, for which increased awareness
among gastroenterologists is warranted. Renal amyloidosis is an infrequent extraintestinal complication of CD that may lead to
chronic kidney impairment. Although evidence-based treatment is lacking, disease activity control is pivotal for management.
Keywords
AmyloidosisCrohn disease
Latin America
Renal insufficiency–chronic
Tumor necrosis factor-alpha
Enlace al recurso
http://www.ochsnerjournal.org/content/21/3/291Fuente
Ochsner Journal; Volumen 21 Número 3 , Páginas 291 - 295 (2021)
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