| Acute renal failure and nephrotic range proteinuria due to amyloidosis in an HIV-infected patient. | |
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MedLine Citation:
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PMID: 17170630 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Case Reports; Journal Article |
Journal Detail:
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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:
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Created Date: 2006-12-15 Completed Date: 2007-02-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370506 Medline TA: Am J Med Sci Country: United States |
Other Details:
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Languages: eng Pagination: 364-7 Citation Subset: AIM; IM |
Affiliation:
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Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. kchan@medicine.umaryland.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amyloidosis / complications* Anti-HIV Agents / therapeutic use Fatal Outcome HIV Infections / complications*, drug therapy Humans Kidney Failure, Acute / etiology* Male Nephrosis / etiology* |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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