Skip to main content
SpringerLink
Log in

Serumspiegel und organablagerungen vonΒ 2-mikroglobulin bei dialysepatienten

Serum values and AB-amyloid deposits in dialysis patients

  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

In radioimmunological estimation ofΒ 2-microglobulin (Β 2m) significant higher serum values were found in 36 dialysis patients (44.4±20.3 mg/l) in comparison with healthy probands (1.5±0.2 mg/l). A significant relation to the duration of dialysis, diuresis, symptoms of the musculo-skeletal system, but not to radiologic changes or bone biopsy findings could be seen. Post mortem examinations carried out in 21 dialysis patients revealed AB-amyloid depositis in synovial tissue of different joints (particularly shoulder and hip joint) or intervertebral discs in eight patients (age 48 to 73 years, dialysis duration less than four years) without correlation to serumΒ 2m level or radiographically suspect areas.

In the tissue of cervical spine or intervertebral discs of two patients suffering from destructive spondylarthropathy no amyloid could be detected. These results suggest that AB-amyloid may occur in elderly patients early in the course of hemodialysis and may be asymptomatic in most cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literatur

  1. Assenat H, Calemard E, Charra B, Laurent G, Terrat JC, Vanel T (1980) Hémodialyse syndrome du canal carpien et substance amyloide. Nouv Press Med 9:1715

    Google Scholar 

  2. Bardin T, Kuntz D, Zingraff J, Voisin M-C, Zelmar A, Lansaman J (1985) Synovial amyloidosis in patients undergoing long-term hemodialysis. Arthr Rheum 28:1052–1058

    Google Scholar 

  3. Bardin T, Kuntz D (1987) The arthropathy of chronic dialysis. Clin Exp Rheum 5:379–386

    Google Scholar 

  4. Benhamou CL, Rouchon JP, Geslin N, Pierre D, Viala JF, Barthez JP (1987) Arthropathies des membres chez les insuffisants rénaux dialysés. Press Mèd 16:119–122

    Google Scholar 

  5. Brown EA, Arnold IR, Gower PE (1986) Dialysis arthropathy: complication of long term treatment with hemodialysis. Brit Med J 292:163–166

    Google Scholar 

  6. Campistol JM, Torras A, Lopez-Pedrez J (1987) Systemic character and visceral involvement of dialysis amyloidosis. Clin Nephrol 28:261

    Google Scholar 

  7. Cary NRB, Sethi D, Brown EA, Erhardt CC, Woodrow DF, Gower PE (1986) Dialysis arthropathy: amyloid or iron? Brit Med J 293:1392–1394

    Google Scholar 

  8. Chanard J, Lavand S, Toupance O, Melin JP, Gillery P (1986)Β 2-microglobulin-associated amyloidosis in chronic hemodialysis patients. Lancet II:1212

    Google Scholar 

  9. Charra B, Calemard E, Uzan M, Terrat JC, Vanel T, Laurent G (1984) Carpal tunnel syndrome, shoulder pain and amyloid deposits in long-term hemodialysis patients. Proc EDTA-ERA 21:291–295

    Google Scholar 

  10. Floege J, Granolleras C, Merscher S, Eisenbach GM, Deschodt G, Colton CK, Shaldon S, Koch KM (1989) Is the rise in plasma beta-2-microglobulin seen during hemodialysis meaningful? Nephron 51:6–12

    Google Scholar 

  11. Gejyo F, Yamada T, Odani S, Nakagawa Y, Arakawa M, Kunitomo T, Kataoka H, Suzuki M, Hirasawa Y, Sirahama T, Cohen AS, Schmidt K (1985) A new form of amyloid protein associated with chronic hemodialysis was identified asΒ 2-microglobulin. Biochem Biophys Res 129:701–706

    Google Scholar 

  12. Gejyo F, Homma N, Arakawa M (1988) Carpal tunnel syndrome andΒ2-microglobulin-related amyloidosis in chronic hemodialysis patients. Blood Purif 6:125–131

    Google Scholar 

  13. Gorevic PD, Casey TT, Stone WJ, Di Raimondo CR, Prelli FC, Frangione B (1985) Beta-2-microglobulin is an amyloidogenic protein in man. J Clin Invest 76:2425–2429

    Google Scholar 

  14. Hampl H, Lobeck H, Bartel-Schwarze S, Stein H, Eulitz M, Linke RP (1987) Clinical, morphologic, biochemical and immunohistochemical aspects of dialysis-associated amyloidosis. Trans Am Soc Artif Intern Organs 23:250–259

    Google Scholar 

  15. Hillon D, Villeboeuf J, Hillon Y, Nakamura S, Bruet A (1985) Appearance of systemic amyloidosis in a chronic hemodialysis patient. Nephron 41:127–128

    Google Scholar 

  16. Huaux JP, Noél H, Malghem J, Maldague B, Devogelaer JP, Nagant de Deuxchaisnes C (1985) Erosive azotemic osteoarthropathy: possible role of amyloidosis. Arthr Rheum 9:1075–1076

    Google Scholar 

  17. Hurst NP, Van den Berg R, Disney A, Alcock M, Albertyn L, Green M, Pascoe V (1989) Dialysis related arthropathy: a survey of 95 patients receiving chronic hemodialysis with special reference to beta-2-microglobulin related amyloidosis. Ann Rheum Dis 48:409–420

    Google Scholar 

  18. Kessler M, Bertheau JM, Aymard B, Grignon B, Azoulay E, Netter P, Gaucher A (1989) Dialysis arthropathy and iron overload. Abstr EDTA, p 170

  19. Kuntz D (1987) Les manifestations articulaires chez l'hemodialyse. In “Arthopathies des dialysés et amylose beta-2-M”, VIIIé Symposium Gambro, pp 7–18

  20. Kuntz D, Naveau B, Bardin Th, Drüeke T, Treves R, Dryll A (1984) Destructive spondylarthropathy in hemodialysed patients. A new syndrome. Arthr Rheum 27:369–375

    Google Scholar 

  21. Ladefoged Chr (1983) Amyloid in osteoarthritic hip joints: deposits in relation to chondromatosis, pyrophosphate, and inflammatory cell infiltrate in the synovial membrane and fibrous capsule. Ann Rheum Dis 42:659–664

    Google Scholar 

  22. Linke RP (1982) Identification of amyloid protein AA with a monoclonal antibody. Blut 45:407–409

    Google Scholar 

  23. Linke RP (1989) Amyloidosen bei Hämodialyse: Unterscheidung der hämodialyseinduzierten von den hämodialyseassoziierten Amyloidose-Formen. Dial J 26:8–15

    Google Scholar 

  24. Linke RP, Hampl H, Bartel-Schwarze S, Eulitz M (1987) Beta-2-Microglobulin, Different Fragments and Polymers thereof in Synovial Amyloid in Long-Term-Hemodialysis. Biol Chem Hoppe-Seyler 368:137–144

    Google Scholar 

  25. Maury CPJ (1990)Β 2-microglobulin amyloidosis. Rheumatol Int 10:1–8

    Google Scholar 

  26. McCarthy JT (1989) Erosive spondylarthropathy in dialysis patients. Sem Dial 2:4–6

    Google Scholar 

  27. Moriniere Ph, Renaud H, El Esper N, Marle A, Houllier S, Deramond H, Sebert JL, Fournier A (1989) Erosive arthropathy and amyloid deposits before hemodialysis — report of 2 cases. Abstr EDTA, p 219

  28. Morita T, Kamimura A, Hirasawa Y (1988) Amyloid deposits in patients on long-term hemodialysis are not always beta-2-microglobulin related. Nephron 50:171–172

    Google Scholar 

  29. Noèl LH, Zingraff J, Bardin T, Atienza C, Kuntz D, Drüeke T (1987) Tissue distribution of dialysis amyloidosis. Clin Nephrol 27:175–179

    Google Scholar 

  30. Nonnast-Daniel B, Schaeffer J, Tekinsoy B, Holch M, Floege J, Brandis A, Galanski M, Eisenbach GM, Koch KM (1989) Cystic bone lesions and spondylarthropathy in chronic HD-patients. Abstr EDTA, p 220

  31. Puchtler H, Sweat F, Levine M (1962) On the binding of Congored by amyloid. J Histochem 10:335–364

    Google Scholar 

  32. Revillard JP, Vincent C, Ramackers JM (1989) Beta-2-Microglobulin: structure, metabolism and alterations in diseases. In: Gejyo F, Brancacchio D, Bardin T (eds) Dialysis Amyloidosis. Wichtig Editore, pp 7–34

  33. Ritz E, Deppisch R, Betz M, Bommer J, Stein G (1989) Beta-2-microglobulin-derived amyloid and osteoarthropathy in dialysis patients. Kidney Metab Bone Dis 2:7–17

    Google Scholar 

  34. Sebert JL, Fardellone P, Deramond H, Marie A, Lansaman J, Bardin T, Lambrey G, Gheerbrant JD, Legars D, Galibert P, Smadja A, Fournier A (1986) Spondylarthropathie destructrice avec dépóts amyloides chez 3 patients en hémodialyse chronique. Rev Rhum 53:459–465

    Google Scholar 

  35. Sethi D, Brown EA, Cary NRB, Woodrow DF, Gower PE (1989) Persistence of dialysis amyloid after renal transplantation. Am J Nephrol 9:173–174

    Google Scholar 

  36. Shirahama T, Gejyo F, Yamada T, Arakawa M, Skinner P, Suzuki M, Hirasawa Y (1985) Histochemical and immunhistochemical characterization of amyloid associated with chronic hemodialysis asΒ 2-microglobulin. Lab Invest 53:705–709

    Google Scholar 

  37. Stein G, Carlsohn H, Schaefer K, Abendroth K, Marzoll D, Sperschneider H, Günther K, Wessel G (1989) Klinische Bedeutung der Beta-2-Mikroglobulin — Bestimmung (Β 2-M) bei Dialysepatienten. Z Urol Nephrol 82:265–272

    Google Scholar 

  38. Stein G, Schauer St, Süss J, Müller A, Hüller M, Schaefer K, Falkenhagen D, Lin\ W (1990) Influence of membranes on generation of Β2-m and release of leukocyte lysosomal enzymes. Int J Artif Organs (in press)

  39. Vanholder CR, Ringoir SM (1990) Intradialytic body weight changes and dialyzer pore size as main contributing factors to the evolution of beta-2-microglobulin in dialysis. Blood Purif 8:32–44

    Google Scholar 

  40. Vincent C, Revillard JP, Galland M, Traeger J (1978) SerumΒ 2-microglobulin in hemodialyzed patients. Nephron 21:260–268

    Google Scholar 

  41. Wright JR, Calkins E, Humphrey RL (1977) Potassium permanganate reaction in amyloidosis. A histologic method to assist in differentiating forms of this disease. Lab Invest 36:274–281

    Google Scholar 

  42. Wullbrand A, Saeger W, Missmahl H-P, Voigt C, Linke RP (1990) Amyloid in intervertebral discs of surgery and autopsy material. A new class of amyloid? Virchows Arch A Pathol Anat 416:335–341

    Google Scholar 

  43. Zingraff J, Noél LH, Bardin T, Kuntz D, Dubost C, Drüeke T (1990)Β 2-microglobulin amyloidosis: a sternoclavicular joint biopsy study in hemodialysis patients. Clin Nephrol 2:94–97

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Innere Medizin, Universität Jena, Deutschland

    G. Stein

  2. Institut für Pathologie, Universität Jena, Deutschland

    A. Schneider & H. To\

  3. Institut für Immunologie, Universität München, Deutschland

    R. Linke

  4. St.-Joseph-Krankenhaus Berlin/West, Deutschland

    K. Schaefer

  5. Sektion Nephrologie, Medizinische Universitätsklinik Heidelberg, Deutschland

    E. Ritz

Authors
  1. G. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. To\
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Linke
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Schaefer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Ritz
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stein, G., Schneider, A., To\, H. et al. Serumspiegel und organablagerungen vonΒ 2-mikroglobulin bei dialysepatienten. Klin Wochenschr 68, 1150–1155 (1990). https://doi.org/10.1007/BF01798067

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01798067

Key words

Search

Navigation