Drug abusers, particularly those who inject drugs s.c. (''skin popping
''), may develop amyloidosis, Chronic infections are thought to play a
pathogenetic role in this setting. A patient is presented who had a h
istory of ''skin popping'' cocaine and heroin and developed nephrotic
syndrome, with an elevated serum creatinine and a creatinine clearance
of 61 ml/min. Renal biopsy demonstrated amyloidosis. Treatment with c
olchicine was initiated, and proteinuria decreased to near normal leve
ls after 12 months, Concomitant with the decrease in proteinuria, crea
tinine clearance improved, although a repeat renal biopsy failed to sh
ow any significant improvement in amyloid burden. These observations s
uggest that colchicine may be a useful treatment in reversing the prot
einuria of renal amyloidosis associated with drug abuse. Furthermore,
clinical improvement may occur before any demonstrable regression in t
he amyloidosis.