Assuntos
Transplante de Células-Tronco Hematopoéticas , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/terapia , Púrpura Trombocitopênica Idiopática/terapia , Adolescente , Adulto , Transfusão de Sangue Autóloga , Terapia Combinada , Feminino , Humanos , Masculino , Recidiva , Transplante Autólogo , Resultado do TratamentoRESUMO
Based on the authors' experience from 1982 to 1990 it was noted that out of 26 cases of renal amyloidosis in the presence of nonpurulent and purulent conditions 2 patients (7%) demonstrated the association with systemic lupus erythematosus (SLE). It was also noted that amyloidosis developed in the patients with a long history of the disease. Long-course immunosuppression treatment could be regarded as the other factor-of-risk for amyloidosis development. Histochemical examination of both patients demonstrated that amyloid deposits in the renal glomeruli were resistant to the potassium permanganate effect and consisted of AL-protein. The results obtained indicated the possibility of appearance of immunoglobulins AL--the proteins of the primary amyloidosis--synthesized in the spectrum in the SLE presence as well as their deposition in the renal glomeruli. As a possible cause of proteinuria and the nephrotic syndrome in SLE patients amyloidosis should be diagnosed in the life time and be regarded in the choice of therapeutic policy as well as in the assessment of pulse immunosuppressive therapy practicability.