Summary
We report light- and electron microscopic findings in glomerular amyloidosis (secondary amyloidosis), which occured after recurrent empyema of the pleura. After healing of the empyema, the clinical symptoms disappeared, over a period of eight years.
During the acute stage of the disease (grade II–III amyloidosis) when the nephrotic syndrome was present, amyloid deposits were seen in the mesangium and on both sides of the basement membrane of the glomerular capillaries. Furthermore, denuded basement membrane areas showing the passage of amyloid into the urinary space, and invaginations of the podocyte by straightened amyloid fibrils were found. After clinical recovery (except for a trace of proteinuria), the renal amyloidosis had electronmicroscopically transformed from an active into an inactive or resting form, while the amount of amyloid present was almost the same. In the areas of amyloid deposits, reparative changes were observed, especially in the area of the mesangial cells and of the podocytes. The podocytes were separated from the persisting amyloid deposits by newly formed basement membrane material.
Similar content being viewed by others
References
Bari, W.A., Pettengill, D.S., Sorenson, G.D.: Electron microscopy and electron microscopic autoradiography of splenic cellcultures from mice with amyloidosis. Lab. Invest. 20, 234–242 (1969)
Bohle, A., Fischbach, H., Wehner, H., Woerz, U., Edel, H.H., Kluthe, R., Scheler, F.: Minimal change lesion with nephrotic syndrome and focal glomerular sclerosis. Clinical Nephrology 2, 52–58 (1974)
Ishihara, T.: Experimental amyloidosis using silver nitrate electron microscopic study on the relationship between silver granules. Amyloid fibriles and reticuloendothelial Systeme. Acta Path. Jap. 23, 439–464 (1973)
Kimura, K., Kihara, I., Kitamura, Sh.: The fine structure of glomerular epithelial cells in experimental renal amyloidosis. Acta Path. Jap. 24, 779–796 (1974)
Kühn, K.W., Ryan, G.B., Hein, St.J., Galaske, R.G., Karnovsky, M.J.: An ultrastructural study of the mechanisms of proteinuria in rat nephrotoxic nephritis. Lab. Invest. 36, 375 (1977)
Lowenstein, J., Gallo, G.: Remission of the nephrotic syndrome in renal amyloidosis. New Engl. J. Med. 282, 128–132 (1970)
Neale, T.J., B. Med. Sc., M.B., Ch.B.: Amyloid fibrils in urinary sediment. New Engl. J. Med. 294, 444–445 (1976)
Polliack, A., Laufer, A., Chloe Tal: Studies of the resorption of experimental amyloidosis. Brit. J. exp. Path. 51, 236–241 (1970)
Richter, G.W.: The resorption of amyloid under experimental conditions. Am. J. Path. 30, 239–261 (1954)
Rosenblatt, M.B.: Recovery from generalized amyloidosis secondary to pulmonary tuberculosis. Arch. Int. Med. 57, 562–565 (1936)
Rosenthal, C.J., Franklin, E.C.: Serum amyloid A (SAA) protein-interaction with itself and serum albumin. J. Immunol. 119, 2 (1977)
Shirahama, T., Cohen, A.S.: Intralysomal formation of amyloid fibrils. Am. J. Path. 81, 101–110 (1975)
Sorensen, G.D., Heefner, W.A., Kirkpatrick, J.B.: Experimental amyloidosis. Am. J. Path. 44, 629–644 (1964)
Triger, D.R., Joekes, A.M.: Renal amyloidosis. A fourteen-year follow up. Quart. J. Med. New Series XLII 165, 15–40 (1973)
Waldenström, H.: On the formation and disappearance of amyloid in man. Acta Chir. Scand. 63, 479–530 (1928)
Williams, G.: Histological studies in resorption of experimental amyloid. J. Path. Bact. 94, 331–336 (1967)
Wright, J.R., Ozdemir, A.I., Matsuzaki, M., Binette, P., Calkins, E.: Amyloid resorption: Possible role of multinucleated giant cells. The apparent failure of Penicillamine treatment. Hopkins Med. J. 130, 278–288 (1972)
Author information
Authors and Affiliations
Additional information
Supported by the Deutsche Forschungsgemeinschaft
Rights and permissions
About this article
Cite this article
Gise, H.v., Helmchen, U., Mikeler, E. et al. Correlations between the morphological and clinical findings in a patient recovering from secondary generalised amyloidosis with renal involvement. Virchows Arch. A Path. Anat. and Histol. 379, 119–129 (1978). https://doi.org/10.1007/BF00432481
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00432481