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NDT Advance Access published online on July 16, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn392
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


AA amyloidosis due to chronic oxalate arthritis and vasculitis in a patient with secondary oxalosis after jejunoileal bypass surgery

Tom Cornelis1, Bert Bammens1, Evelyne Lerut2, Luc Cosyn3, Gerda Goovaerts4, René Westhovens5 and Yves Vanrenterghem1

1 Department of Nephrology and Renal Transplantation 2 Department of Morphology and Molecular Pathology, University Hospitals Leuven, Leuven 3 Department of Nephrology 4 Department of Pathology, AZ Sint-Augustinus, Wilrijk 5 Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium

Correspondence and offprint requests to: Bert Bammens, Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Catholic University of Leuven, Herestraat 49, B-3000 Leuven, Belgium. Tel: +32-16-344580; Fax +32-16-344599; E-mail: Bert.Bammens{at}uz.kuleuven.ac.be



  Abstract

We report a case of a woman with secondary oxalosis after jejunoileal bypass surgery for obesity, who presented with oxalate stone disease and renal insufficiency requiring dialysis. Thirty years after surgery, longstanding osteoarticular symptoms were recognized as oxalate arthritis. Eventually, she also developed oxalate vasculitis, which improved with corticoid treatment and intensification of dialysis. Work-up for kidney transplantation revealed AA amyloidosis on gastric and colonic biopsies. Since no other cause of chronic inflammation could be identified, it was concluded that the amyloidosis was secondary to oxalate arthritis and vasculitis. To our knowledge, this is the first report on this association.

Keywords: AA amyloidosis; bariatric surgery; hyperoxaluria; oxalate arthritis

Received for publication: 16. 6.08
Accepted in revised form: 20. 6.08


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