Document Detail


Combined treatment with cyclophosphamide and prednisolone can induce remission of nephrotic syndrome in a patient with renal amyloidosis, associated with rheumatoid arthritis.
MedLine Citation:
PMID:  7923963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 67-year-old woman, who had been diagnosed with classical rheumatoid arthritis (RA), was admitted to our hospital because of massive proteinuria. Biopsy of the kidney revealed deposition of amyloid fibrils in the subepithelial and subendothelial spaces of the glomerular capillary walls. Though the treatment with prednisolone and dipyridamole against nephrotic syndrome and amyloidosis due to RA was not effective, cyclophosphamide, which was added after tapering of prednisolone, was able to induce remission of nephrotic syndrome after two years. The levels of CRP and serum amyloid A protein (SAA) returned to within the normal limits. As the impairment of renal function is thought to be due to deposition of amyloid supplied from the precursors of amyloid fibrils filtered from the general circulation in RA patients, remission of nephrotic syndrome might result from the suppression of production of SAA or removal of amyloid fibrils. Cyclophosphamide, which has the potential both to suppress disease activity in RA and to produce degradation of amyloid fibrils in glomeruli, may be useful against renal or systemic amyloidosis complicated by RA.
Authors:
A Maezawa; K Hiromura; H Mitsuhashi; Y Tsukada; H Kanai; S Yano; T Naruse
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  42     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  1994 Jul 
Date Detail:
Created Date:  1994-11-18     Completed Date:  1994-11-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  30-2     Citation Subset:  IM    
Affiliation:
Third Department of Internal Medicine, Gunma University School of Medicine, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amyloidosis / drug therapy,  etiology*,  pathology
Arthritis, Rheumatoid / complications*
Cyclophosphamide / therapeutic use*
Drug Therapy, Combination
Female
Humans
Kidney / pathology
Kidney Diseases / drug therapy,  etiology*,  pathology
Nephrotic Syndrome / drug therapy*,  etiology*,  pathology
Prednisolone / therapeutic use*
Chemical
Reg. No./Substance:
50-18-0/Cyclophosphamide; 50-24-8/Prednisolone

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


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