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2.
Nephrol Ther ; 18(7): 655-657, 2022 Dec.
Article in French | MEDLINE | ID: mdl-36428150

ABSTRACT

INTRODUCTION: Bladder localization of AA amyloidosis is rare. It can be responsible for massive and recurrent hematuria. We report a case of bladder AA amyloidosis secondary to Crohn's disease in a renal transplant patient. CLINICAL OBSERVATION: A 62-year-old man, suffering from Crohn's disease since 1991 complicated by renal AA amyloidosis. He received a kidney transplant since 20 years from an HLA identical donor. After an 18-year period of clinical remission, the patient was admitted for a flare-up of his Crohn's disease in the form of intermittent diarrhoea. Treatment with corticosteroids allowed a good evolution. A year later, he was rehospitalized for massive macroscopic haematuria. Histological examination of the bladder biopsy revealed AA amyloidosis. The patient fully recovered but died 6 weeks later from septic shock of urinary origin. CONCLUSION: The treatment of bladder localization of AA amyloidosis is based on treating the cause. Hematuria is sometimes massive, exceptionally requiring emergency cystectomy for haemostasis.


Subject(s)
Amyloidosis , Crohn Disease , Male , Humans , Middle Aged , Urinary Bladder/pathology , Crohn Disease/complications , Amyloidosis/complications , Amyloidosis/diagnosis , Amyloidosis/therapy , Kidney/pathology
3.
Urol Case Rep ; 34: 101469, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33294375

ABSTRACT

Primary bladder amyloidosis is rare. Hematuria is the most common form of it's revelation. There are no specific clinical and paraclinical signs to differentiate it from urothelial tumors. The diagnosis is histological. We are reporting you a case of incidental discovery.

4.
J Int Med Res ; 48(10): 300060520940452, 2020 Oct.
Article in English | MEDLINE | ID: mdl-33054497

ABSTRACT

We herein present a case involving a 23-year-old woman with gross hematuria. Cystoscopy revealed abnormal areas of the mucosa along the anterior and posterior bladder walls. These abnormalities were suspicious for neoplasia; however, a diagnosis was not established by subsequent biopsy. The patient underwent transurethral resection biopsy in which an isolated lesion along the anterior wall was completely resected and the others were left untreated. Pathologic examination and special staining led to a diagnosis of amyloidosis, and the patient elected to undergo transurethral surgery 1 month later. During the operation, the intravesical lesions were found to have significantly improved in both the treated and untreated sites. The operation was cancelled, follow-up was arranged, and no other treatment was administered. Repeat cystoscopy examinations at 3 and 9 months after surgery showed that the lesions had almost completely disappeared.


Subject(s)
Immunoglobulin Light-chain Amyloidosis , Urinary Bladder Neoplasms , Adult , Biopsy , Cystoscopy , Female , Humans , Male , Remission, Spontaneous , Urinary Bladder/diagnostic imaging , Urinary Bladder/surgery , Urinary Bladder Neoplasms/surgery , Young Adult
5.
CEN Case Rep ; 9(4): 413-417, 2020 11.
Article in English | MEDLINE | ID: mdl-32572782

ABSTRACT

The presence of amyloid deposits in bladder walls is a rare histological finding. It can be linked to primary (limited to bladder) or secondary (systemic, associated with chronic inflammatory disorders) amyloidosis. Secondary bladder involvement is very uncommon; it usually presents with gross hematuria, which is challenging to manage, due to frail bladder mucosa and/or necrosis. We present a case of 54-year old man with secondary bladder amyloidosis due to Crohn's disease, that caused gross hematuria and severe anemia, which was managed conservatively by endoscopic transurethral resection, diatermocoagulation, clot evacuation and urinary drainage by bilateral percutaneous nephrostomy, with spontaneous resolution. Secondary bladder amyloidosis is a rare condition that presents with severe hematuria, difficult to control with standard management. Owing to chronic nature of the disease, treatment should be aimed to a conservative approach whenever possible. In case of failure, invasive procedures should be considered as salvage therapies.


Subject(s)
Amyloidosis/etiology , Amyloidosis/therapy , Crohn Disease/complications , Hematuria/surgery , Amyloidosis/diagnosis , Amyloidosis/pathology , Anemia/etiology , Endoscopy/methods , Hematuria/etiology , Hematuria/prevention & control , Humans , Male , Middle Aged , Nephrostomy, Percutaneous/methods , Severity of Illness Index , Treatment Outcome , Urinary Bladder Diseases/pathology
6.
Transl Androl Urol ; 8(5): 548-555, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31807431

ABSTRACT

Secondary bladder amyloidosis is a rare condition with less than 60 cases published in the world. It is usually secondary to chronic inflammatory processes such as rheumatologic diseases. Hematuria is its predominant and most important symptom, and usually occurs after a bladder catheterization. The diagnostic confirmation is made through a pathological and immunohistochemical study. The treatment must be staggered from less to more invasive. Our objectives are to present a new case of secondary bladder amyloidosis in a woman with a history of chronic bronchiectasis after tuberculosis and frequent super infections, whose main manifestation was a massive hematuria, and review this rare pathology. We have obtained very good initial results using intravesical instillations with dimethyl sulfoxide (DMSO) with complete resolution of the hematuria, the patient remaining asymptomatic for 6 months. After that, there was a recurrence of the hematuria that was treated with embolization of the hypogastric arteries, with good results. We can conclude that, despite being a rare condition, we must consider secondary bladder amyloidosis in patients who have already been diagnosed with systemic amyloidosis and/or chronic pathologies who develop hematuria after bladder catheterization. Based on our experience, instillations with dimethyl sulfoxide are a safe option and provide a quick and temporary resolution of hematuria symptoms.

7.
Urol Case Rep ; 17: 111-113, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29541594
8.
BMC Res Notes ; 9(1): 473, 2016 Oct 19.
Article in English | MEDLINE | ID: mdl-27760547

ABSTRACT

BACKGROUND: Secondary bladder amyloidosis is an extremely rare disease, resulting from a chronic systematic inflammatory disorder associated with amyloid deposits. Although uncommon in Japan, familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent episodes of fever of short duration and serositis and is frequently associated with systemic amyloidosis. Here, we present a case of a Japanese patient complaining of fever and macroscopic hematuria after a living donor renal transplantation. Consequently, he was diagnosed with secondary bladder amyloidosis with FMF. CASE PRESENTATION: A 64-year-old Japanese male received a living ABO-incompatible kidney transplant from his wife. The postoperative clinical course was normal, and the patient was discharged 21 days after the transplantation with a serum creatinine level of 0.78 mg/dl. The patient frequently complained of general fatigue and fever of unknown origin. Six months later, the patient presented with continuous general fatigue, macroscopic hematuria, and fever. Cystoscopic examination of the bladder showed an edematous region with bleeding, and a transurethral biopsy revealed amyloid deposits. His wife stated that the patient had a recurrent high fever since the age of 40 years and that his younger brother was suspected to have a familial autoinflammatory syndrome; thus, the patient was also suspected to have a familial autoinflammatory syndrome. Based on his brother's medical history and the genetic tests, which showed a homozygous mutation (M694V/M694V) for the Mediterranean fever protein, he was diagnosed with FMF. Although colchicine treatment for FMF was planned, the patient had an untimely death due to heart failure. We re-evaluated the pathological findings of the various tissue biopsies obtained during the treatment after the renal transplantation. Immunohistochemistry revealed amyloid deposits in the bladder region, renal allograft, and myocardium and the condition was diagnosed as AA amyloidosis associated with FMF. CONCLUSION: We presented a case of systemic amyloidosis with FMF, involving the bladder region, myocardium, and renal allograft, diagnosed after renal transplantation. Bladder amyloidosis should be considered in patients with macroscopic hematuria, particularly in the kidney transplant recipients with idiopathic chronic renal disease. Diagnosis of secondary bladder amyloidosis may result in the early detection of underlying diseases, which may contribute to patient prognosis.


Subject(s)
Amyloidosis/diagnosis , Familial Mediterranean Fever/complications , Kidney Transplantation , Living Donors , Urinary Bladder Diseases/diagnosis , Amyloidosis/complications , Humans , Male , Middle Aged , Urinary Bladder Diseases/complications
9.
Rev. cuba. med ; 53(2): 230-236, abr.-jun. 2014.
Article in Spanish | LILACS | ID: lil-722973

ABSTRACT

Se presentó el caso de un paciente, de 38 años de edad, con hematurias macroscópicas desde 3 años antes de su ingreso, acompañadas de síntomas disúricos. Se comprobó, por cistoscopia, la existencia de una lesión vegetante que ocupaba todo el trígono y parte lateral derecha de la vejiga. Tras su resección endoscópica y estudio histológico se diagnosticó como amiloidosis vesical. Se observó buena evolución posquirúrgica. No se halló afección amiloidótica en otras regiones del organismo...


A case of a male 38 year-old patient, with macroscopic hematuria for 3 years before admission is presente here. This hematuria is accompanied by dysuria symptoms. It was found by cystoscopy, the existence of a vegetative lesion occupying the entire right side of trigone and bladder. After endoscopic resection and histological study, bladder amyloidosis was diagnosed. Good surgical outcome was observed. No amyloid disease was found in other body areas...


Subject(s)
Humans , Amyloidosis
10.
Rev. cuba. med ; 53(2): 230-236, abr.-jun. 2014.
Article in Spanish | CUMED | ID: cum-61532

ABSTRACT

Se presentó el caso de un paciente, de 38 años de edad, con hematurias macroscópicas desde 3 años antes de su ingreso, acompañadas de síntomas disúricos. Se comprobó, por cistoscopia, la existencia de una lesión vegetante que ocupaba todo el trígono y parte lateral derecha de la vejiga. Tras su resección endoscópica y estudio histológico se diagnosticó como amiloidosis vesical. Se observó buena evolución posquirúrgica. No se halló afección amiloidótica en otras regiones del organismo(AU)


A case of a male 38 year-old patient, with macroscopic hematuria for 3 years before admission is presente here. This hematuria is accompanied by dysuria symptoms. It was found by cystoscopy, the existence of a vegetative lesion occupying the entire right side of trigone and bladder. After endoscopic resection and histological study, bladder amyloidosis was diagnosed. Good surgical outcome was observed. No amyloid disease was found in other body areas(AU)


Subject(s)
Humans , Cystoscopy/methods , Amyloidosis/surgery
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