A Case of Rapidly Progressive Renal Failure with Unearthed Amyloidosis

Main Article Content

Pulak Azad*
Lakshmi Kant Jha
Yasir Sultan Rizvi
Pranav Tyagi

Abstract

Amyloidosis-associated kidney disease commonly manifests with chronic glomerular symptoms including heavy proteinuria predominantly albuminuria. Clinical presentation ranges from full-blown nephrotic syndrome, hematuria, and hypertension to renal failure. In India patients with chronic kidney disease are mainly attributed to hypertension and diabetes but an underlying etiology such as amyloidosis needs to be unearthed and shouldn’t be ignored as an etiology. We report a case of a 60-year-old man with hypertension and hypothyroidism who presented with frothy urine for several years, b/l pedal edema for 15 days. Over the past 3 months, there was a serial increase in creatinine. As per CKD-EPI equation, the patient was CKD-4. As the patient was suspected to be rapidly progressive renal failure; a renal biopsy was planned. Biopsy reports were suggestive of Amyloidosis. Glomerular, vascular, and tubulointerstitial deposition of amyloid was seen. Based on renal biopsy and IHC staining; the patient’s diagnosis was AA-associated secondary renal amyloidosis. Thus in this case renal amyloidosis was an unearthed etiology.

Article Details

Azad, P., Jha, L. K., Rizvi, Y. S., & Tyagi, P. (2025). A Case of Rapidly Progressive Renal Failure with Unearthed Amyloidosis. Journal of Clinical Nephrology, 9(2), 024–026. https://doi.org/10.29328/journal.jcn.1001148
Case Reports

Copyright (c) 2025 Azad P, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Bridoux F, Fermand JP. Monoclonal immunoglobulin-related glomerular diseases and renal amyloidosis. In: Johnson RJ, Floege J, Tonelli M, editors. Comprehensive clinical nephrology. 7th ed. Philadelphia: Elsevier; 2024;323-336.

Çelebi ZK, Kiremitçi S, Sadioğlu RE, Keven K. Rapidly progressive renal failure in AA amyloidosis: A new clinical and histopathological entity for an old disease. Turk J Nephrol. 2020;29(4):289-296. Available from: https://turkjnephrol.org/Content/files/sayilar/423/289-296.pdf

Costa M, Greenfield H, Pereira R, Chuva T, Henrique R, Cunha C. A rare case of renal AA amyloidosis secondary to Sjögren's syndrome. EJCRIM. 2019;6:001226. Available from: https://doi.org/10.12890/2019_001226

Mir TH, Zargar PA, Sharma A, Jabeen B, Sharma S, Parvaiz MO, et al. Post-COVID-19 AA amyloidosis of the kidneys with rapidly progressive renal failure. Prion. 2023;17(1):111-115. Available from: https://doi.org/10.1080/19336896.2023.2201151

Anupama YJ, Vankalakunti M. Rapidly progressive glomerulonephritis in a patient with renal amyloidosis: Case report and review of the literature. Indian J Nephrol. 2012 Sep-Oct;22(5):377-380. Available from: https://doi.org/10.4103/0971-4065.103931

Crosthwaite A, Skene A, Mount P. Rapidly progressive glomerulonephritis complicating primary AL amyloidosis and multiple myeloma. Nephrol Dial Transplant. 2010 Aug;25(8):2786-2789. Available from: https://doi.org/10.1093/ndt/gfp715

Muñiz-Pacios L, Morales-Ruiz E, Aguilar F, García-Martín F. Chronic renal failure secondary to systemic amyloidosis associated with gastrointestinal stromal tumor. Nefrologia. 2013;33(4):620-622. Available from: https://doi.org/10.3265/nefrologia.pre2013.apr.11964

Costa M, Greenfield H, Pereira R, Chuva T, Henrique R, Cunha C. A rare case of renal AA amyloidosis secondary to Sjögren's syndrome. EJCRIM. 2019;6. Available from: https://www.ejcrim.com/index.php/EJCRIM/article/view/1226/1788

Kukuy OL, Beckerman P, Dinour D, Ben-Zvi I, Livneh A. Amyloid storm: acute kidney injury and massive proteinuria, rapidly progressing to end-stage kidney disease in AA amyloidosis of familial Mediterranean fever. Rheumatology (Oxford). 2021 Jul 1;60(7):3235-3242. Available from: https://doi.org/10.1093/rheumatology/keaa772