Renal Amyloidosis: clinicopathologic and evolutive characteristics of Morrocan
series

Sara FASSIL*, Lahoucine ALTIT, Wafaa FADILI, Inass LAOUAD.
Page No. 1-7

Background and objectives : Systemicamyloidosis is a disease resulting from extracellular
deposition of fibrillar protein in different organs. The kidney is the organ most commonly involved
in systemicamyloidosis. The aim of this study is to evaluate the clinicopathologic and evolutive
characteristic of a renalamyloidosis series including 21 patients. Results: The average age at
diagnosis was 53+/- 11.9 years, with a sex ratio H/F of 2.5. The clinical picture was dominated by
nephrotic syndrome, noted in 66% cases; a renal failure is noted in 28.5% patients. The diagnosis
of amyloidosis is carried on renal biopsy in 20 cases, in most of cases. AL amyloidosis was noted in
4 patients (19%), all cases were secondary to multiple myeloma. AA amyloidosis was noted in 17
patients (80.9%), mainly caused by chronic infections in 42 %, pulmonary tuberculosis was noted in
8 patients, a digestive tuberculosis was found in one patient. Chronic inflammatory rheumatisms
were noted in 3 patients (14%), one case of rheumatoid polyarthritis, one case of psoriatic arthritis,
and one case of systemic lupus eryhtematosus. An association of pulmonary tuberculosis and
rheumatoid polyarthritis was noted in two patients (9.5%). Solid cancer was found in one case.
Bronchiectasies, without tuberculosis history, were noted in 2 patients (9.5%). Evolution was
marked by the setting of end stage renal disease in 5 patients, with an average of 9mois. Death
occurred in 3 patients. 8 patients were progressing to chronic renal kidney disease; 5 patients were
lost of view. Conclusion: Amyloidosis is a progressive and fatal disease. Complications of endstage
renal disease are the main causes of death. The treatment is the one of the causal disease. In
our context, predominance of AA amyloidosis is noted; so we have to improve the infectious
diseases care, in order to reduce the prevalence of this affection.
Keywords : amyloidosis ; renal biopsy; etiologies ; evolution.