The features of bone articular lesions in dialysis-related amyloidosis (DRA) and criteria for the clinical diagnosis of DRA

Shinichi Nishi,Kenmei Takaichi,Suguru Yamamoto,Hironobu Naiki,Junichi Hoshino

doi:10.1186/s41100-019-0205-z

Shinichi Nishi, Kenmei Takaichi + Show 3 more

Open Access

https://doi.org/10.1186/s41100-019-0205-z

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Abstract

We introduced criteria for the clinical diagnosis of dialysis-related amyloidosis (DRA) from the Amyloidosis Research Group study supported by a Grant-in-Aid from the Ministry of Health, Labour and Welfare of Japan. DRA exhibits various kinds of bone articular lesions, such as carpal tunnel syndrome, trigger finger, destructive spondyloarthropathy, spinal canal stenosis, and joint pains. These bone articular lesions, excluding destructive spondyloarthropathy, are observed in non-dialysis patients or dialysis patients without DRA. We carefully compared these lesions between DRA and non-DRA patients and summarized the differences between them. The incidence age, male to female ratio, and coincidence rate were distinct between these groups of patients. Biopsies from bone articular lesions are invasive and burdensome for dialysis patients; therefore, a precise clinical diagnosis is required for DRA. We discussed the validity and availability of our proposed criteria.

Highlights

Dialysis-related amyloidosis (DRA) is a type of systemic amyloidosis
Compared to the clinical features of other types of systemic amyloidosis, such as immunoglobulin light chain amyloidosis (AL) and inflammatory amyloidosis (AA) types, the clinical features of dialysis-related amyloidosis (DRA) are distinct in terms of preferential amyloid deposition at multiple bone articular lesions
Trigger finger (TF) [3], destructive spondyloarthropathy (DSA) [4, 5], spinal canal stenosis (SCS) [6], and joint pains [7, 8] have been identified as bone articular lesions associated with DRA

Summary

Introduction

Dialysis-related amyloidosis (DRA) is a type of systemic amyloidosis. Compared to the clinical features of other types of systemic amyloidosis, such as immunoglobulin light chain amyloidosis (AL) and inflammatory amyloidosis (AA) types, the clinical features of DRA are distinct in terms of preferential amyloid deposition at multiple bone articular lesions. Carpal tunnel syndrome (CTS) was reported as a common bone articular lesion of DRA [1, 2]. Trigger finger (TF) [3], destructive spondyloarthropathy (DSA) [4, 5], spinal canal stenosis (SCS) [6], and joint pains [7, 8] have been identified as bone articular lesions associated with DRA. We surveyed the prevalence of bone articular lesions from dialysis patients with various vintage groups, ranging from short to long.

Results

Conclusion