+ Most Popular
Cunninghamia lanceolata plantations in China
Mammalian lairs in paleo ecological studies and palynology
Studies on technological possibilities in utilization of anhydrous milk fat for production of recombined butter-like products
Should right-sided fibroelastomas be operated upon?
Large esophageal lipoma
Apoptosis in the mammalian thymus during normal histogenesis and under various in vitro and in vivo experimental conditions
Poissons characoides nouveaux ou non signales de l'Ilha do Bananal, Bresil
Desensitizing efficacy of Colgate Sensitive Maximum Strength and Fresh Mint Sensodyne dentifrices
Administration of fluid by subcutaneous infusion: revival of a forgotten method
Tundra mosquito control - an impossible dream?
Schizophrenia for primary care providers: how to contribute to the care of a vulnerable patient population
Geochemical pattern analysis; method of describing the Southeastern limestone regional aquifer system
Incidence of low birth weights in a hospital of Mexico City
Graded management intensity of grassland systems for enhancing floristic diversity
Microbiology and biochemistry of cheese and fermented milk
The ember tetra: a new pygmy characid tetra from the Rio das Mortes, Brazil, Hyphessobrycon amandae sp. n. (Pisces, Characoidei)
Risk factors of contrast-induced nephropathy in patients after coronary artery intervention
Renovation of onsite domestic wastewater in a poorly drained soil
Observations of the propagation velocity and formation mechanism of burst fractures caused by gunshot
Systolic blood pressure in a population of infants in the first year of life: the Brompton study
Haematological studies in rats fed with metanil yellow
Studies on pasteurellosis. I. A new species of Pasteurella encountered in chronic fowl cholera
Dormancy breaking and germination of Acacia salicina Lindl. seeds
therapy of lupus nephritis. a two-year prospective study

A rare case of reversible acquired AA-type renal amyloidosis in a chronic filariasis patient receiving antifilarial therapy

A rare case of reversible acquired AA-type renal amyloidosis in a chronic filariasis patient receiving antifilarial therapy

Clinical and Experimental Nephrology 15(4): 591-595

ISSN/ISBN: 1342-1751

PMID: 21519822

DOI: 10.1007/s10157-011-0448-7

Lymphatic filariasis is a major health problem in India with a large number of patients tending to be asymptomatic. In the Southeast and South Asian regions, Wuchereria bancrofti is the most prevalent parasite, causing filariasis in 99.4% of cases. While kidney involvement is a rare event in chronic filariasis, this case is unique because AA-type renal amyloidosis occurs in chronic W. bancrofti infection. We present here a unique case of lymphatic filariasis. The patient, a 25-year-old male who was previously diagnosed with right lower limb filarial lymphedema and had undergone lymphovenous anastomosis, was admitted for evaluation of persistent nephrotic-range proteinuria. Autoimmune markers in the form of anti-nuclear antibodies, anti-double-stranded DNA and anti-neutrophil cytoplasmic antibody were negative; C3 was normal. Urine analysis revealed inactive sediment with moderate proteinuria. Both serum and urine electrophoresis were negative for paraproteins and bone marrow aspirate and biopsy were normal. Evidence of active filarial infection was established on the basis of microfilariae in the peripheral smear and a positive W. bancrofti antigen test. Kidney biopsy revealed renal amyloidosis when stained with Congo red and anti-AA immunostain. The patient's proteinuria improved on conservative management with angiotensin-converting enzyme inhibitors and a course of antifilarial drugs. His proteinuria returned to <1 g/24 h with normalization of renal function and no significant proteinuria on periodic follow-up at 6-month and 1-year intervals. Repeat kidney biopsy after 1.5 years showed regression of amyloidosis. Repeat demonstration of filarial antigen and microfilariae in the peripheral smear were negative on multiple occasions during the follow-up period. Although various chronic infections can lead to secondary renal amyloidosis, this is the first case reported in world literature where secondary amyloidosis developed as a complication of chronic filarial infection due to W. bancrofti. This is probably also the first case reported in world literature where renal amyloidosis has an etiological association with W. bancrofti infection and where patient symptoms improved with antifilarial and antiproteinuric management.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 036079070

Download citation: RISBibTeXText

Related references

Eagle's syndrome: an unusual cause of recurrent neck pain in a child. Bmj Case Reports 13(1), 2020

Systemic amyloidosis of beta 2 microglobulin type and acquired renal cystic disease with disseminated carcinoma arising in a patient on long term hemodialysis. Journal of Pathology 154(1): 46A-47A, 1988

Amyloidosis in allergic processes: renal amyloidosis (reversible in appearance) and urticaria. Renal amyloidosis and asthma. Revista Clinica Espanola 135(6): 591-595, 1974

Acquired factor VIII inhibitor in a patient with chronic myelogenous leukemia receiving interferon-alfa therapy. Annals of PharmacoTherapy 34(6): 737-739, 2000

Reversible, nonoliguric acute renal failure in a patient with rheumatoid arthritis and renal amyloidosis. New York State Journal of Medicine 86(10): 542-543, 1986

Effective therapy with tranexamic acid in a case of chronic disseminated intravascular coagulation with acquired alpha2-antiplasmin deficiency associated with AL amyloidosis. Thrombosis and Haemostasis 102(6): 1285-1287, 2009

Severe reversible thrombocytopenia caused by recombinant human granulocyte colony-stimulating factor in an AIDS patient receiving chronic ganciclovir therapy. Aids 11(11): 1403-1405, 1997

Amyloid A-type renal amyloidosis in a patient with sarcoidosis: report of a case and review of the literature. Clinical Nephrology 60(4): 284-288, 2003

A rare case of peliosis hepatis in a patient with chronic renal failure and renal cell carcinoma. Clinical Journal of Gastroenterology 13(3): 403-407, 2020

Rare case of reversible acute symmetrical lesions of the bilateral Basal Ganglia associated with diabetic nephropathy and chronic renal failure. Journal of Clinical Imaging Science 4: 29, 2014

A rare case of acquired haemophilia in a patient with chronic myelomonocytic leukaemia successfully treated with decitabine. Haemophilia: the Official Journal of the World Federation of Hemophilia 20(1): E92-E94, 2014

Immunology analysis on specific antifilarial antibody and subclass of chronic filariasis cases. Chinese Journal of Parasitic Disease Control 14(2): 107-108, 2001

Renal damage in a chronic active hepatitis C patient receiving interferon-alpha therapy. Nihon Jinzo Gakkai Shi 40(2): 48-53, 1998

A patient with amyloidosis, vesicoureteral reflux and renal cell adenoma complicated by intrarenal calcification and acquired cystic renal disease. Nephron 72(2): 322, 1996

A Case of Reversible Dilated Cardiomyopathy after -Interferon Therapy in a Patient with Renal Cell Carcinoma. American Journal of the Medical Sciences 324(6): 331-334, 2002