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What is the Diagnosis Basis of Amyloid Nephropathy

2012-09-22 17:57

Amyloid Nephropathy is a kind of renal lesion caused by the deposition of amyloid and in the early stage the main symptom is proteinuria and nephrotic syndrome and in the end stage it will develop into renal failure if left untreated or improperly treated. Amyloid usually affects multiple organs and there are various clinical manifestations and this is certain difficulty for correct diagnosis. Therefore it is very necessary to know the diagnosis basis of amyloid nephropathy so as to have timely and proper preventions and treatments once the disease is confirmed.

The basic diagnostic basis for amyloid nephropathy:

1. Above 40 years old and have recent proteinuria or nephrotic syndrome and at the same time there is involvement of other organs.

2. Chronic infectious disease or rheumatoid arthritis and have proteinuria or nephrotic syndrome.

3. Multiple myeloma or other malignant tumors and have massive proteinuria

4. Deposition of amyloid protein in the renal biopsy.

If a nephrotic syndrome patient is above 40, renal tubule is damaged and the hematuria is not severe and if he or she has one of the following symptoms, amyloid nephropathy should be highly suspected:

1. loss of weight;

2. hypotension or the ratio of systolic pressure and diastolic pressure is reduced by more than 20mmHg or myocardial hypertrophy.

3. enlargement of liver and spleen, but there is no obvious abnormal liver function or tongue hypertrophy.

4. there are monoclonal immunoglobulin light chain in the blood and urine immune electrophoresis.

It has been shown in statistics that there are up to 65.6% patients have monoclonal immunoglobulin light chain in their blood and urine and the blood and urine immune electrophoresis is recommended for nephrotic syndrome patients that are above 40.

The examination of immunoglobulin light chain in the immunofluorescence test has relatively high specificity for diagnosing AL type, however due to the the deficiency of some light chain, the result can sometimes be negative. Therefore it needs combine the monoclonal belt in the electrophoresis. And the immunohistochemical staining AA protein has high sensitivity and specificity in the diagnosis of AA type.

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