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Renal Amyloid Deposition and Nephrotic Syndrome

Patricia Conolly, MD; Wu-Hao Tu, MD; Claude G, Biava, MD
Arch Intern Med. 1984;144(1):198. doi:10.1001/archinte.1984.00350130230043.
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To the Editor.  —Proteinuria and the nephrotic syndrome in renal amyloidosis are generally believed to be related to the deposition of amyloid in renal glomeruli, especially in the capillary wall1 or, at least, in the mesangium in the early stage.2 A recent article, however, suggested that the nephrotic syndrome in renal amyloidosis may not correlate with amyloid deposition in the kidney, which progressed despite clinically improved nephrotic syndrome and renal function.3

Report of a Case.  —We observed a 69-year-old man for whom a renal biopsy specimen (obtained while he was nephrotic) showed no abnormality of the glomeruli, except fusion of the epithelial foot processes. Specifically, amyloid was not apparent in the glomeruli, when viewed by light microscopic examination of the Congo redstained specimen or by electron microscopy. There was a single spot that stained positive with Congo red in the wall of a renal artery. A bone


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