Fr. Danesh et al., Fatal cervical spondyloarthropathy in a hemodialysis patient with systemicdeposition of beta(2)-microglobulin amyloid, AM J KIDNEY, 33(3), 1999, pp. 563-566
Destructive spondyloarthropathy is a serious complication in patients with
end-stage renal disease, We report a case of fatal cervical spondyloarthrop
athy in a patient on hemodialysis who presented with severe pain in the cer
vical area. Magnetic resonance imaging (MRI) of the cervical spine showed a
soft tissue mass at the cervico-occipital hinge with spinal cord compressi
on and destructive lesions of the cervical vertebrae, The patient became qu
adriplegic during the MRI procedure and died a few days later. Postmortem e
xamination showed deposition of beta(2)-microglobulin in the cervico-occipi
tal hinge, A unique feature of this case was the documented presence of sys
temic beta(2)-microglobulin amyloid deposits involving the spleen that to o
ur knowledge has not been reported previously. Clinical suspicion end early
detection of lesions caused by dialysis-related amyloidosis (DRA) may help
to prevent significant morbidity and mortality in long-term dialysis patie
nts. (C) 1999 by the National Kidney Foundation, Inc.