التفاصيل البيبلوغرافية
| العنوان: |
Control of AA amyloidosis complicating Crohn's disease: a clinico-pathological study. |
| المؤلفون: |
Denis, Marie A.1, Cosyns, Jean‐Pierre2, Persu, Alexandre3, Dewit, Olivier1, Galocsy, Chantal4, Hoang, Pierre1, Maldague, Philippe5, Wallemacq, Pierre6, Zerbib, Frank7, Fiasse, René1 |
| المصدر: |
European Journal of Clinical Investigation. Mar2013, Vol. 43 Issue 3, p292-301. 10p. 4 Charts, 1 Graph. |
| مصطلحات موضوعية: |
*AMYLOIDOSIS, *CROHN'S disease, *IMMUNOSUPPRESSIVE agents, *KIDNEY disease diagnosis, *PROTEINURIA, *NEPHROTIC syndrome, *TUMOR necrosis factors |
| مستخلص: |
Background Immunosuppressive drugs may prevent or partially reverse progression of renal AA-amyloidosis, a rare complication of Crohn's disease, often fatal due to renal failure. Materials and methods The clinical, biological and pathological data of 16 patients treated since 1976 were reviewed. Serum amyloid A was determined in surviving patients. Results The median age of the 16 patients (13 men) was 23·5 years (range 16-69). At Crohn's disease onset, Montreal phenotypes were similar to reported data. Out of 15 patients with renal insufficiency, 8 developed a nephrotic syndrome and 7 a low grade proteinuria. The single patient without renal insufficiency had nephrotic syndrome. A significant correlation ( P < 0·05) between the extension of renal amyloid A and sclerosis was found in 12 patients. One patient had a 10 year remission of nephrotic syndrome with immunosuppressive drugs. In 6 patients treated with anti- TNF-α (Tumor-Necrosis-Factor-α) agents, anaphylactic reaction (1/6), death from septic shock (1/6), 5-year remission (1/6) or reduction of nephrotic syndrome (1/6) and stabilization of renal insufficiency (2/6) were observed. Surgery was performed in 10 patients. Kidney transplantation was performed in 5 of the 8 patients dialysed for end-stage renal failure. Among 6/16 patients (37%) still alive, 3 belong to the 5 transplanted patients (survival: 3-20 years) and 3 to the anti- TNF-α drugs treated patients; all but one exhibited a low serum amyloid A level. Conclusions Suppression of Crohn's disease inflammation potentially leads to the control of amyloid A production, assessed by a decrease of serum amyloid A. Kidney transplantation provides a long survival. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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