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Case Report



Early presentation of renal amyloidosis in a patient with pulmonary tuberculosis

Mani Tiwari, Mahendra Z Patel, Khyati Shamaliya.




Abstract

Amyloidosis is a potentially life-threatening disorder caused by deposition of insoluble fibrillar proteins in various tissues, which commonly results in organ dysfunction or failure. Amyloidosis, either primary or secondary, can be diagnosed by the presence of a beta-pleated sheet configuration on X-ray diffraction examination, a fine fibrillar nonbranching appearance on electron microscopy, and an apple-green birefringence when examined under polarized light after staining with Congo red. In developing countries, tuberculosis is still the commonest underlying cause for renal amyloidosis, with an incidence of 9%–11% among patients with tuberculosis. In contrast to the common belief, renal amyloidosis can be observed in patients with comparatively short-term tuberculosis and even after adequate treatment. Here, we report a case of renal amyloidosis in a patient with tuberculosis rousing clinical suspicion as the patient presented with a triad of pedal edema, proteinuria, and medical renal disease on ultrasound, which was confirmed later by biopsy as renal amyloidosis secondary to tuberculosis.

Key words: Tuberculosis, renal amyloidosis






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