HISTOMORPHOLOGICAL PATTERNS OF RENAL AMYLOIDOSIS - A CORRELATION BETWEEN HISTOLOGY AND CHEMICAL TYPE OF AMYLOIDOSIS

A retrospective study was conducted to investigate whether there was a correlation between the histological pattern of renal amyloidosis, th e chemical type of amyloid protein involved and the clinical presentat ion. Eighteen consecutive cases of systemic amyloidosis that had renal biopsies processed and examined histopathologically at the Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur were reviewed. The age range of patients was 25 to 64 ys (mean, 46 yr s), The male: female ratio was 2.6:1. Three patients were Malay, 9 Chi nese, 3 Indian, 1 Indonesian, 1 Iban, and 1 Bisaya. According to the p redominant site of amyloid deposition, 14 cases showed a glomerular pa ttern and 4 a vascular pattern. 8 cases were designated as 2 anti-huma n amyloid-A (AA) amyloidosis on the basis of permanganate-sensitivity and immunoreactivity of deposits with anti-human AA protein antibody. Ten cases contained deposits that were permanganate-resistant and noni mmunoreactive for AA protein and were designated as AL in type. The hi stomorphologic pattern of renal amyloidosis did not provide a reliable means of differentiating AA from AL amyloidosis, The glomerular patte rn tended to present with renal manifestations such as nephrotic syndr ome and chronic renal failure, whereas the vascular pattern tended to present with nonrenal manifestations such as diarrhoea, These findings may have a bearing on the pathophysiology of amyloidosis and provide clues to appropriate management. Hmi PATHOL 28:847-849. Copyright (C) 1997 by W.B. Saunders Company.