Etiologic profile of amyloidosis in Tunisia at elderly

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Published Jan 26, 2012
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Vol. 90 No. 1 (2012): Issue Jan 2012

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Khaoula Ben Abdelghani
Samia Barbouch
Mondher Ounissi
Mondher Ounissi
Médiha Mahfoudhi
Fatma Ben Moussa
Rym Goucha
Sami Turki
Adel Kheder

Abstract

Background: The amyloidosis is one of the histhologic lesions the most frequently associated to the aging.
Aim: To identify the several etiologies of amyloidosis in elderly patients according to immunohistochemical type.
Methods: Retrospective study on 10 years, in Internal medicine and Nephrology department in Charles Nicolle Hospital. Tunis. Tunisia. Diagnosis of amyloidosis was retained after histological confirmation with specific colorations, in patients aged 65 years or more at the diagnose of amyloidosis.
Results: The study enrolled 51 patients with amyloidosis. In 67% of cases it was AA amyloidosis. The etiology the most frequently observed with this type was the tuberculosis, followed by chronic pulmonary infections. We retained diagnose of non AA amyloidosis in 21% of patients. The multiple myeloma has been the most frequent etiology observed, but no cause was identified at about half of patients. Twelve per cent of amyloidosis were not typed.
Conclusion: From our study, we can remark the high predominance of AA amyloidosis, probably because of frequency of tuberculosis which is still high in our country, this is not in accordance with occidental data, were AL amyloidosis and senile amyloidosis predominate in elderly.

Keywords:

Amyloidosis; Elderly; Myeloma; Tuberculosis

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References

  1. Cornwell GG, Johnson KH, Westermark P. The age related amyloids: a growing family of unique biochemical substances. J Clin Pathol 1995;48: 984-89.
  2. Maguy Bertrand N. Les amyloses à transthyrétine. Rev Med Interne 2007; 28:306-13.
  3. Cornwell GG, Murdoch WL, Kyle RA, Westermark P, Pitkanen P. Frequency distribution of senile cardiovascular amyloid. A clinicopathologic correlation. Am. J. Med. 1983; 75: 618-23.
  4. Westermark P, Johansson B, Natvig JB. Seneil cardiac amyloidosis: evidence of two different amyloid substances in the ageing heart. Scand. J. Immunol 1979;10:303-8
  5. Merlini G, Bellotti V. Molecular mehanisms of amyloidosis. N Engl J Med 2003; 349: 583-96
  6. Simms RW, Prout MN, Cohen AS. The epidemiology of AL and AA amyloidosis. Baillieres Clin Rheumatol. 1994;8:627-34.
  7. Ben Maiz H, Abderrahim E, Ben Moussa F, Goucha R, Karoui C. Evolution du spectre des néphropathies glomérulaires en Tunisie de 1975 à 2005. Ses rapports avec l'évolution sanitaire et sociale.Bull. Acad. Natle Méd. 2006; 190 : 403-18
  8. Ng B, Connors L.H, Davidoff R, Skinner M, Falk R.H. Senile systemic amyloidosis presenting with heart failure: a comparison with light-chain amyloidosis. Arch. Intern. Med. 2005; 27: 1425-9.
  9. Tuglular S, Yalcinkaya F, Paydas S et al. A retrospective analysis for aetiology and clinical findings of 287 secondary amyloidosis cases in Turkey. Nephrol Dial Transplant. 2002; 17: 2003-5.
  10. Noël LH. Amylose systémique : diagnostic en pratique. Néphrol Ther 2010 ; 6 : 88-96
  11. Satoskar AA, Burdge K, Cowden DJ, Nadasdy GM, Hebert LA, Nadasdy T. Typing of amyloidosis in renal biopsies: diagnostic pitfalls. Arch Pathol Lab Med 2007; 131:917-22
  12. Von Hutten H, Mihatsch M, Lobeck H, Rudolph B, Eriksson M, Roken C. Prevalence and origin of Amyloid in kidney biopsies. Am J Surg Pathol 2009;33:1198-1205
  13. Hazenberg BPC, Van Rijswijk MH. Clinical and therapeutic aspects of AA amyloidosis. Clin Rheumatol. 1994; 8: 661-90.
  14. Barsoum RS. End-stage renal disease in North Africa. Kidney Int Suppl. 2003; 83:S111-4
  15. Malhotra P, Agarwal R, Awasthi A, Jindal S.K, Srinivasan R. How long does it take for tuberculosis to cause secondary amyloidosis? Eur J Intern Med. 2005; 16:437-9
  16. Lance NJ, Curran JJ. Amyloidosis in a case of ankylosing spondylitis with a review of the litterature. J Rheumatol, 1991; 18: 100-3
  17. Elizabeth A. Garthwaite, Leslie Sellars, Sunil Bhandari. Carcinoma of the bronchus presenting as renal failure secondary to amyloidosis. Nephrol Dial Transplant. 2003; 18:1031
  18. Beji S, Kaaroud H, Ben Moussa F, et al. Amylose rénale compliquant l'évolution des colites inflammatoires chroniques. Presse Med. 2004; 33:862-5.
  19. Salles M, Ortiz Santamaria V, Riera E, Olive A. Secondary amyloidosis induced by hydatid cyst. Med Clin (Barc). 2004:16;123:519
  20. Kaaroud H, Ben Moussa F, Beji S, Kheder A, Ben Maiz H. Renal amyloidosis secondary to hydatid cyst of the liver. Clinical remission after surgical excision. Nephrologie. 2002;23:213-7
  21. Hill JC, Maske R, Bowene RM. Secondary localized amyloidosis of the cornea associated with tertiary syphilis. Cornea. 1990; 9:98-101.
  22. Saba M, Tohmé A, Abadjian G, Haddad F, Ghayad E. Amyloses multisystémiques. Étude clinique de 39 patients au Liban. Presse Med. 2005; 34: 640 - 6
  23. Gertz MA, Kyle RA, Ofallon WM. Primary systemic amyloidosis: a rare complication of immunoglobulin monoclonal gammapathies and Waldenström's disease. Blood. 1991; 77:257- 62.
  24. Desikan KR, Dhodapkar MV, Hough A, et al. Incidence and impact of light chain associated (AL) amyloidosis on the prognosis of patients with multiple myeloma treated with autologous transplantation. Leuk Lymphoma. 1997; 27: 315-9.