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Nephrology Dialysis Transplantation, Vol 14, Issue 6 1467-1471, Copyright © 1999 by Oxford University Press

ORIGINAL ARTICLES

Clinical, radiological and serum amyloid P component scintigraphic features of {beta}2-microglobulin amylidosis associated with continuous ambulatory peritoneal dialysis

S Tan, R Baillod, E Brown, K Farrington, C Soper, M Percy, E Clutterbuck, S Madhoo, M Pepys and P Hawkins
Immunological Medicine Unit and Renal Unit, Hammersmith Hospital, London, UK; Renal Unit, Royal Free Hospital and Charing Cross Hospital, London, UK; Renal Unit, Lister Hospital, Stevenage, Herts, UK; Renal Unit, St Helier Hospital, Carshalton, Surrey, UK; Corresponding author at: Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur 59100, Malaysia

Background: {beta}2-Microglobulin ({beta}2M) amyloidosis occurs in patients with end-stage renal failure (ESRF) who undergo long-term continuous ambulatory peritoneal dialysis (CAPD), but its prevalence in patients treated exclusively by CAPD is unknown. In addition, its features may differ from those of haemodialysis-associated {beta}2M amyloidosis because CAPD is more biocompatible. Methods: We performed serum amyloid P component (SAP) scintigraphy, a specific technique for imaging amyloid deposits, in 13 consecutive patients with ESRF who had been dialysed for >5 years, at least 80% of the time by CAPD. Clinical and radiological features of {beta}2M amyloidosis were sought and compared with the results of SAP scintigraphy. Results: SAP scans showed articular amyloid deposits in seven patients, all of whom had evidence of carpal tunnel syndrome and four of whom had arthralgia characteristic of dialysis amyloidosis. Typical radiographic bone cysts were present in only one case who had been dialysed for >17 years. The remaining six patients had no clinical, radiological or scintigraphic evidence of {beta}2M amyloidosis. Conclusions: The prevalence of {beta}2M amyloidosis in this study was comparable with that in reported haemodialysis populations. Many of the amyloid deposits demonstrated by SAP scintigraphy were not associated with symptoms but larger and longer term studies are required to determine whether CAPD favourably influences their clinical expression.
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