ABSTRACT
A case is reported of a 21 year old man who suffered from Castleman's disease and systemic secondary amyloidosis. He was otherwise healthy until development of a history of edema and nocturia over 3 weeks. Physical examination was normal apart from ankle swelling. Renal biopsy showed amyloid deposits in the glomerulus with gentian violet and congo red. Positive staining by antibody against serum amyloid A protein was demonstrated. Nine months later because of persistent nephrotic syndrome, an abdominal tomography was performed and a mesenteric mass was detected. The patient underwent abdominal surgery. The histopathological examination showed plasma cell variant of Castleman disease and AA amyloidosis in the mass. After the removal of mesenteric mass, the proteinuria gradually decreased and disappeared, and no systemic findings were present.
Subject(s)
Amyloidosis/etiology , Castleman Disease/complications , Kidney Diseases/etiology , Nephrotic Syndrome/etiology , Serum Amyloid A Protein/analysis , Adult , Calcinosis/diagnostic imaging , Calcinosis/etiology , Castleman Disease/diagnostic imaging , Castleman Disease/pathology , Castleman Disease/surgery , Humans , Kidney Glomerulus/chemistry , Kidney Glomerulus/pathology , Male , Mesentery , Plasma Cells/pathology , Proteinuria/etiology , Remission Induction , Retroperitoneal Space , Tomography, X-Ray ComputedABSTRACT
Se presenta el caso de un paciente de 21 años de edad, con síndrome nefró- tico y amiloidosis renal, que consultó por edemas en los miembros inferiores y palpebrales de 3 semanas de evolución. A la exploración, salvo los edemas, no había nada a destacar, detectándose en la analítica un síndrome nefrótico. Se realizó una biopsia renal que informó de amiloidosis AA sin encontrar causa que lo justificará. Nueve meses más tarde, ante la persistencia del síndrome nefrótico, se realizó TAC abdominal donde se apreciaba la existencia de una masa que se resecó. El diagnóstico anatomopatológico fue de enfermedad de Castleman, variedad de células plasmáticas. Tras la resección de la masa desaparecieron la proteinuria y las alteraciones analíticas (AU)
A case is reported of a 21 year old man who suffered from Castleman´s disease and systemic secondary amyloidosis. He was otherwise healthy until development of a history of edema and nocturia over 3 weeks. Physical examination was normal apart from ankle swelling. Renal biopsy showed amyloid deposits in the glomerulus with gentian violet and congo red. Positive staining by antibody against serum amyloid A protein was demonstrated. Nine months later because of persistent nephrotic syndrome, an abdominal tomography was performed and a mesenteric mass was detected. The patient underwent abdominal surgery. The histopathological examination showed plasma cell variant of Castleman disease and AA amyloidosis in the mass. After the removal of mesenteric mass the proteinuria was gradually decreased and dissappeared and any sistemic findings were present (AU)
