'Dialysis related arthropathy': a survey of 95 patients receiving chronic haemodialysis with special reference to beta 2 microglobulin related amyloidosis.
Open Access
- 1 May 1989
- journal article
- research article
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 48 (5), 409-420
- https://doi.org/10.1136/ard.48.5.409
Abstract
Ninety five patients receiving chronic haemodialysis (CHD) were surveyed to determine the prevalence of rheumatic disease and, where possible, its aetiology. At least three distinct rheumatic syndromes were identified--a group of patients with a syndrome consisting of large and medium joint synovial swelling, restricted hips and shoulders, tenosynovitis, carpal tunnel syndrome, and bone cysts due to deposition of beta 2 microglobulin related amyloid (AM beta 2m); a second group with erosive azotaemic osteoarthropathy; and a third group with age related degenerative disease of small, large, and axial joints. The data presented suggest that in patients receiving CHD (a) the prevalence of AM beta 2m deposition and the associated syndrome increases with duration of dialysis, but in patients who have been dialysed for more than 10 years the risk of developing AM beta 2m is related to age; (b) AM beta 2m deposition in subchondral cysts, but not synovium, causes joint destruction; also, AM beta 2m may be more prone to deposition in synovium of joints already damaged by other processes; (c) in the absence of synovial iron deposition synovial AM beta 2m is not associated with an inflammatory infiltrate; (d) hyperparathyroidism and perhaps other factors such as synovial iron deposition are probably more important than AM beta 2m as causes of peripheral joint degeneration and destructive spondyloarthropathy in patients receiving CHD.This publication has 43 references indexed in Scilit:
- Clinical picture of the amyloid arthropathy in patients with chronic renal failure maintained on haemodialysis using cellulose membranes.Annals Of The Rheumatic Diseases, 1987
- Carpal tunnel syndrome caused by amyloid containing beta 2 microglobulin: a new amyloid and a complication of long term haemodialysis.Annals Of The Rheumatic Diseases, 1986
- Dialysis arthropathy: amyloid or iron?BMJ, 1986
- Dialysis‐related amyloid is amyloid of beta‐2‐microglobulin (AMβ2M) originArthritis & Rheumatism, 1986
- Serum Levels of β2-Microglobulin as a New Form of Amyloid Protein in Patients Undergoing Long-Term HemodialysisNew England Journal of Medicine, 1986
- Amyloid arthropathy in patients undergoing periodical haemodialysis for chronic renal failure: a new complication.Annals Of The Rheumatic Diseases, 1985
- In vitro formation of amyloid fibrils from intact β2-microglobulinBiochemical and Biophysical Research Communications, 1985
- A new form of amyloid protein associated with chronic hemodialysis was identified as β2-microglobulinBiochemical and Biophysical Research Communications, 1985
- Erosive azotemic osteodystrophyAmerican Journal of Roentgenology, 1981
- Joint Lesions of HyperparathyroidismAnnals Of The Rheumatic Diseases, 1963