Tocilizumab histologically improved AA renal amyloidosis in a patient with multicentric Castleman disease: A case reportâ©.
Clin Nephrol
; 90(3): 232-236, 2018 Sep.
Article
em En
| MEDLINE
| ID: mdl-29701172
ABSTRACT
Multicentric Castleman disease (MCD) is a rare systemic lymphoproliferative disorder and is infrequently associated with renal complications that include amyloid A (AA) amyloidosis. Although it has been reported that patients with MCD and amyloidosis usually have a poor prognosis, recently, tocilizumab, a humanized anti-interleukin-6 receptor antibody, has emerged as an effective and specific treatment for AA amyloidosis secondary to chronic inflammatory disorders. Here we report a case of an MCD patient with secondary AA renal amyloidosis who was successfully treated with tocilizumab. The patient was initially referred to nephrology specialists because of a decline in renal function and proteinuria. Percutaneous renal biopsy revealed the presence of Congo red-positive amorphous depositions and AA protein-positive areas in glomeruli, vessel walls, and interstitium, confirming a diagnosis of renal AA amyloidosis secondary to MCD. At 1 year after starting tocilizumab treatment, a second renal biopsy showed the clearance of amyloid deposits in the interstitium. These observations suggest that tocilizumab may be an effective therapy for AA amyloidosis secondary to MCD.â©.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hiperplasia do Linfonodo Gigante
/
Anticorpos Monoclonais Humanizados
/
Amiloidose
/
Rim
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Nephrol
Ano de publicação:
2018
Tipo de documento:
Article