Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?

In light chain amyloidosis (LA), the massive glomerular and vascular amyloid deposition leading to interstitial fibrosis/tubular atrophy (IFTA) is thought to be responsible for renal failure. The amyloid deposition in the interstitium and the tubular basement membrane (TBM) has received less attenti...

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Main Authors: Csilla Markóth, László Bidiga, László Váróczy, Ibolya File, József Balla, János Mátyus
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2203776
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author Csilla Markóth
László Bidiga
László Váróczy
Ibolya File
József Balla
János Mátyus
author_facet Csilla Markóth
László Bidiga
László Váróczy
Ibolya File
József Balla
János Mátyus
author_sort Csilla Markóth
collection DOAJ
description In light chain amyloidosis (LA), the massive glomerular and vascular amyloid deposition leading to interstitial fibrosis/tubular atrophy (IFTA) is thought to be responsible for renal failure. The amyloid deposition in the interstitium and the tubular basement membrane (TBM) has received less attention in the study of LA. We, therefore, collected clinical and laboratory data on patients diagnosed with LA in our Nephrology Department and studied amyloid deposition in the TBM. Twelve LA patients were diagnosed by renal biopsy during a seven-year period. In 4 of the 12, amyloid deposition could also be detected in the TBM. In our first case of a patient with diabetes mellitus, non-amyloid fibrils resembling ‘diabetic fibrillosis’ were also seen by electron microscopy. Despite the double damage, IFTA was negligible, blood vessels were unaffected, and the glomerular deposition was segmental. In the other three cases, significant (>50%) IFTA and a severely reduced estimated glomerular filtration rate were already detected at the time of diagnosis and amyloid deposition was also observed in the blood vessels. These findings indicate the importance of TBM amyloid deposition in the progression of renal disease. This may represent a late-stage presentation of the disease with a heavy LC burden.
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institution Kabale University
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publishDate 2023-12-01
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series Renal Failure
spelling doaj-art-5cb133e45f0b4ec8ae7007e93039c1d92025-08-20T03:48:57ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2203776Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?Csilla Markóth0László Bidiga1László Váróczy2Ibolya File3József Balla4János Mátyus5Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, HungaryKálmán Laki Doctoral School, University of Debrecen, Debrecen, HungaryDivision of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDivision of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDivision of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDivision of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, HungaryIn light chain amyloidosis (LA), the massive glomerular and vascular amyloid deposition leading to interstitial fibrosis/tubular atrophy (IFTA) is thought to be responsible for renal failure. The amyloid deposition in the interstitium and the tubular basement membrane (TBM) has received less attention in the study of LA. We, therefore, collected clinical and laboratory data on patients diagnosed with LA in our Nephrology Department and studied amyloid deposition in the TBM. Twelve LA patients were diagnosed by renal biopsy during a seven-year period. In 4 of the 12, amyloid deposition could also be detected in the TBM. In our first case of a patient with diabetes mellitus, non-amyloid fibrils resembling ‘diabetic fibrillosis’ were also seen by electron microscopy. Despite the double damage, IFTA was negligible, blood vessels were unaffected, and the glomerular deposition was segmental. In the other three cases, significant (>50%) IFTA and a severely reduced estimated glomerular filtration rate were already detected at the time of diagnosis and amyloid deposition was also observed in the blood vessels. These findings indicate the importance of TBM amyloid deposition in the progression of renal disease. This may represent a late-stage presentation of the disease with a heavy LC burden.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2203776Proteinurialight chain amyloidosistubular basement membranemonoclonal gammopathy of renal significancemultiple myeloma
spellingShingle Csilla Markóth
László Bidiga
László Váróczy
Ibolya File
József Balla
János Mátyus
Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?
Renal Failure
Proteinuria
light chain amyloidosis
tubular basement membrane
monoclonal gammopathy of renal significance
multiple myeloma
title Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?
title_full Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?
title_fullStr Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?
title_full_unstemmed Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?
title_short Tubular basement membrane amyloid deposition: is it an indicator of renal progression in light chain amyloidosis?
title_sort tubular basement membrane amyloid deposition is it an indicator of renal progression in light chain amyloidosis
topic Proteinuria
light chain amyloidosis
tubular basement membrane
monoclonal gammopathy of renal significance
multiple myeloma
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2203776
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