Renal amyloidosis: new perspectives
It has been recognized for more than 100 years that some forms of renal disease are associated with, or even due to, amyloidosis. Early papers merely described deposits of amorphous eosinophilic material. After Congo Red was introduced as a stain for amyloid, many reports appeared of the type exemplified by the publication of Heptinstall and Joekes  who, on studying the kidneys of patients with rheumatoid arthritis, were intrigued by finding amyloid primarily in the glomerular tufts and the basement membrane with little tubular involvement until late in disease. These descriptions were followed by the application of ultrastructural techniques and the discovery that amyloid is fibrillar [2–6]. In the kidney, such fibrils are seen in the region referred to as the mesangium, in close proximity to endo- and epithelial cells as well as within the basal lamina, particulary where they are thickened (Figs 1A and B). During the past two decades, when it became clear that amyloid may represent many different precursor proteins, it has even become possible to define the type of amyloid protein deposited in the kidney with the help of specific antisera which can be used on the light as well as on the electron microscopic level.
KeywordsFamilial Mediterranean Fever Carpal Tunnel Syndrome Mesangial Cell Amyloid Fibril Amyloid Formation
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