Document Detail


Acute renal failure and nephrotic range proteinuria due to amyloidosis in an HIV-infected patient.
MedLine Citation:
PMID:  17170630     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Amyloidosis is an uncommon cause of renal disease in HIV-positive patients. Diagnosis is challenging, treatment options are limited, and prognosis remains poor. We discuss an HIV-positive patient with acute renal failure and nephrotic range proteinuria. The differential diagnosis included nephropathy due to trimethoprim/sulfamethoxazole, tenofovir, HIV, hepatitis C, heroin, or multifactorial causes. Serum and urine study findings were inconclusive. Rapid clinical deterioration ensued and a renal biopsy was performed. Pathologic examination revealed eosinophilic, amorphous material in the glomerular tufts that stained red-orange with Congo red stain. Immunohistochemical analysis confirmed amyloid A (AA) amyloidosis. AA amyloidosis occurs as a complication of chronic infection or chronic inflammatory disease. It has been reported in intravenous or subcutaneous drug abusers, some of whom were HIV-positive. This case underscores the importance of tissue diagnosis to determine the cause of renal disease in HIV-positive patients. Clinical diagnosis, based on CD4 count, viral load, and degree of proteinuria, may not predict the pathological diagnosis in HIV-positive patients.
Authors:
Kirk M Chan-Tack; Navneet Ahuja; Edward J Weinman; Ravinder K Wali; Anayochukwu Uche; Lisa A Greisman; Cinthia Drachenberg; Philip N Hawkins; Robert R Redfield
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  332     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-15     Completed Date:  2007-02-07     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  364-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / etiology*
Adult
Amyloidosis / complications*
Anti-HIV Agents / therapeutic use
Fatal Outcome
HIV Infections / complications*,  drug therapy
Humans
Male
Nephrosis / etiology*
Grant Support
ID/Acronym/Agency:
G7900510//Medical Research Council
Chemical
Reg. No./Substance:
0/Anti-HIV Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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