伴有淀粉样蛋白风暴的家族性地中海热:病例报告与文献综述

Radwa M. Abdelsattar , Youstina Mohsen , Kholoud Mohamed El Sherif , Emad Samaan
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引用次数: 0

摘要

家族性地中海热(FMF)的不良并发症之一是淀粉样变性肾病,通常在10-20年内悄无声息地发展为终末期肾病(ESRD)。然而,该病例却迅速发展为 ESRD,其原因被怀疑是淀粉样蛋白风暴。一名 28 岁的男性患者因急性肾损伤 (AKI)、大量蛋白尿和高血清炎症指标被转诊至曼苏拉大学医院(MUH)肾内科,既往病史已证实其患有 FMF 长达五年。入院时病情恶化,血清肌酐迅速升高,不得不开始进行血液透析。肾组织病理学报告显示,患者肾脏淀粉样蛋白沉积严重。出院三个月后的随访中,患者开始依赖血液透析。该病例表明,怀疑 FMF 患者出现淀粉样蛋白风暴非常重要。
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Familial mediterranean fever associated with amyloid storm: A case report with literature review

One of the adverse complications of familial Mediterranean fever (FMF) is amyloid nephropathy, which usually progresses silently within 10–20 years into end-stage renal disease (ESRD). However, this case presented with rapid progression to ESRD, and the cause is suspected to be an amyloid storm. There are only a few cases that were reported to have developed this condition.

A 28-year-old male patient with a proven past medical history of FMF for five years was referred to the nephrology service of Mansoura University Hospitals (MUH) with acute kidney injury (AKI), heavy proteinuria, and high serum inflammatory markers. The condition deteriorated with rapidly increasing serum creatinine during admission and necessitated starting hemodialysis. Renal histopathology reported heavy renal amyloid deposition. The patient became hemodialysis dependent in the follow-up visits three months after discharge. This case raises the importance of suspecting an amyloid storm in FMF patients.

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