AA renal amyloidosis: Clinical observations over 20 years

Abstract

Objective: AA renal amyloidosis is present in Algeria, often secondary to chronic infections, the most frequent being tuberculosis. We studied the evolution of the epidemiology of AA amyloidosis over a period of 20 years.

Materials and methods: We conducted a retrospective study of all adult and pediatric patients diagnosed with renal symptomatology of AA amyloidosis from 1994 to 2014 inclusive. The diagnosis was made by renal biopsy performed on native kidneys in the majority of patients, and the biopsy was read by the same pathologist. 378 patients were studied in two groups: G1: 1994 through 2004; G2: 2005 through 2014.

Results: The mean age at presentation increased from 42.07 ± 15.82 in G1 to 44.90 ± 14.4 years in G2 (p < 0.00008). Male gender was predominant in both groups. For the comparison of underlying diseases between G1 and G2 we found an increase of inflammatory diseases from 42.84% to 54.6% (p < 0.0011) with a decrease of idiopathic causes from 29.7 to 19.7% (p < 0.042).

Conclusion: This work shows a decrease in infectious causes and an increase in inflammatory causes of AA amyloidosis, reflecting the progress of antibiotic therapy as well as the protocol put in place by our country to fight tuberculosis. AA amyloidosis of uncertain etiologies has been seen to be decreasing due to better identification of certain inflammatory causes, in particular familial Mediterranean fever.