Renal amyloidosis: Origin and clinicopathologic correlations of 474 recent cases

Samar M. Said, Sanjeev M Sethi, Anthony M. Valeri, Nelson Leung, Lynn D. Cornell, Mary E. Fidler, Loren Herrera Hernandez, Julie A. Vrana, Jason D. Theis, Patrick S. Quint, Ahmet Dogan, Samih H. Nasr

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Background and objectives The kidney is the organ most commonly involved in systemic amyloidosis. This study reports the largest clinicopathologic series of renal amyloidosis. Design, setting, participants, & measurements This study provides characteristics of 474 renal amyloidosis cases evaluated at the Mayo Clinic Renal Pathology Laboratory from 2007 to 2011, including age, sex, serum creatinine, proteinuria, type of amyloid, and tissue distribution according to type. Results The type of amyloid was Ig amyloidosis in 407 patients (85.9%), AA amyloidosis in 33 (7.0%), leukocyte chemotactic factor 2 amyloidosis in 13 (2.7%), fibrinogen A a chain amyloidosis in 6 (1.3%), Apo AI, Apo AII, or Apo AIV amyloidosis in 3 (0.6%), combined AA amyloidosis/Ig heavy and light chain amyloidosis in 1 (0.2%), and unclassified in 11 (2.3%). Laser microdissection/mass spectrometry, performed in 147 cases, was needed to determine the origin of amyloid in 74 of the 474 cases (16%), whereas immunofluorescence failed to diagnose 28 of 384 light chain amyloidosis cases (7.3%). Leukocyte chemotactic factor 2 amyloidosis and Apo AI, Apo AII, or Apo AIV amyloidosis were characterized by diffuse interstitial deposition, whereas fibrinogen A a chain amyloidosis showed obliterative glomerular involvement. Compared with other types, Ig amyloidosis was associated with lower serum creatinine, higher degree of proteinuria, and amyloid spicules. Conclusions In the authors' experience, the vast majority of renal amyloidosis cases are Ig derived. The newly identified leukocyte chemotactic factor 2 amyloidosis form was the most common of the rarer causes of renal amyloidosis. With the advent of laser microdissection/mass spectrometry for amyloid typing, the origin of renal amyloidosis can be determined in >97% of cases.

Original languageEnglish (US)
Pages (from-to)1515-1523
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume8
Issue number9
DOIs
StatePublished - 2013

Fingerprint

Amyloidosis
Kidney
Amyloid
Chemotactic Factors
Apolipoprotein A-II
Microdissection
Leukocytes
Apolipoprotein A-I
Proteinuria
Fibrinogen
Mass Spectrometry
Creatinine
Lasers
Light
Immunoglobulin Heavy Chains
Tissue Distribution

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Renal amyloidosis : Origin and clinicopathologic correlations of 474 recent cases. / Said, Samar M.; Sethi, Sanjeev M; Valeri, Anthony M.; Leung, Nelson; Cornell, Lynn D.; Fidler, Mary E.; Hernandez, Loren Herrera; Vrana, Julie A.; Theis, Jason D.; Quint, Patrick S.; Dogan, Ahmet; Nasr, Samih H.

In: Clinical Journal of the American Society of Nephrology, Vol. 8, No. 9, 2013, p. 1515-1523.

Research output: Contribution to journalArticle

Said, SM, Sethi, SM, Valeri, AM, Leung, N, Cornell, LD, Fidler, ME, Hernandez, LH, Vrana, JA, Theis, JD, Quint, PS, Dogan, A & Nasr, SH 2013, 'Renal amyloidosis: Origin and clinicopathologic correlations of 474 recent cases', Clinical Journal of the American Society of Nephrology, vol. 8, no. 9, pp. 1515-1523. https://doi.org/10.2215/CJN.10491012
Said, Samar M. ; Sethi, Sanjeev M ; Valeri, Anthony M. ; Leung, Nelson ; Cornell, Lynn D. ; Fidler, Mary E. ; Hernandez, Loren Herrera ; Vrana, Julie A. ; Theis, Jason D. ; Quint, Patrick S. ; Dogan, Ahmet ; Nasr, Samih H. / Renal amyloidosis : Origin and clinicopathologic correlations of 474 recent cases. In: Clinical Journal of the American Society of Nephrology. 2013 ; Vol. 8, No. 9. pp. 1515-1523.
@article{8365879be16a4e2ca31c1fc8ed1be652,
title = "Renal amyloidosis: Origin and clinicopathologic correlations of 474 recent cases",
abstract = "Background and objectives The kidney is the organ most commonly involved in systemic amyloidosis. This study reports the largest clinicopathologic series of renal amyloidosis. Design, setting, participants, & measurements This study provides characteristics of 474 renal amyloidosis cases evaluated at the Mayo Clinic Renal Pathology Laboratory from 2007 to 2011, including age, sex, serum creatinine, proteinuria, type of amyloid, and tissue distribution according to type. Results The type of amyloid was Ig amyloidosis in 407 patients (85.9{\%}), AA amyloidosis in 33 (7.0{\%}), leukocyte chemotactic factor 2 amyloidosis in 13 (2.7{\%}), fibrinogen A a chain amyloidosis in 6 (1.3{\%}), Apo AI, Apo AII, or Apo AIV amyloidosis in 3 (0.6{\%}), combined AA amyloidosis/Ig heavy and light chain amyloidosis in 1 (0.2{\%}), and unclassified in 11 (2.3{\%}). Laser microdissection/mass spectrometry, performed in 147 cases, was needed to determine the origin of amyloid in 74 of the 474 cases (16{\%}), whereas immunofluorescence failed to diagnose 28 of 384 light chain amyloidosis cases (7.3{\%}). Leukocyte chemotactic factor 2 amyloidosis and Apo AI, Apo AII, or Apo AIV amyloidosis were characterized by diffuse interstitial deposition, whereas fibrinogen A a chain amyloidosis showed obliterative glomerular involvement. Compared with other types, Ig amyloidosis was associated with lower serum creatinine, higher degree of proteinuria, and amyloid spicules. Conclusions In the authors' experience, the vast majority of renal amyloidosis cases are Ig derived. The newly identified leukocyte chemotactic factor 2 amyloidosis form was the most common of the rarer causes of renal amyloidosis. With the advent of laser microdissection/mass spectrometry for amyloid typing, the origin of renal amyloidosis can be determined in >97{\%} of cases.",
author = "Said, {Samar M.} and Sethi, {Sanjeev M} and Valeri, {Anthony M.} and Nelson Leung and Cornell, {Lynn D.} and Fidler, {Mary E.} and Hernandez, {Loren Herrera} and Vrana, {Julie A.} and Theis, {Jason D.} and Quint, {Patrick S.} and Ahmet Dogan and Nasr, {Samih H.}",
year = "2013",
doi = "10.2215/CJN.10491012",
language = "English (US)",
volume = "8",
pages = "1515--1523",
journal = "Clinical Journal of the American Society of Nephrology",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "9",

}

TY - JOUR

T1 - Renal amyloidosis

T2 - Origin and clinicopathologic correlations of 474 recent cases

AU - Said, Samar M.

AU - Sethi, Sanjeev M

AU - Valeri, Anthony M.

AU - Leung, Nelson

AU - Cornell, Lynn D.

AU - Fidler, Mary E.

AU - Hernandez, Loren Herrera

AU - Vrana, Julie A.

AU - Theis, Jason D.

AU - Quint, Patrick S.

AU - Dogan, Ahmet

AU - Nasr, Samih H.

PY - 2013

Y1 - 2013

N2 - Background and objectives The kidney is the organ most commonly involved in systemic amyloidosis. This study reports the largest clinicopathologic series of renal amyloidosis. Design, setting, participants, & measurements This study provides characteristics of 474 renal amyloidosis cases evaluated at the Mayo Clinic Renal Pathology Laboratory from 2007 to 2011, including age, sex, serum creatinine, proteinuria, type of amyloid, and tissue distribution according to type. Results The type of amyloid was Ig amyloidosis in 407 patients (85.9%), AA amyloidosis in 33 (7.0%), leukocyte chemotactic factor 2 amyloidosis in 13 (2.7%), fibrinogen A a chain amyloidosis in 6 (1.3%), Apo AI, Apo AII, or Apo AIV amyloidosis in 3 (0.6%), combined AA amyloidosis/Ig heavy and light chain amyloidosis in 1 (0.2%), and unclassified in 11 (2.3%). Laser microdissection/mass spectrometry, performed in 147 cases, was needed to determine the origin of amyloid in 74 of the 474 cases (16%), whereas immunofluorescence failed to diagnose 28 of 384 light chain amyloidosis cases (7.3%). Leukocyte chemotactic factor 2 amyloidosis and Apo AI, Apo AII, or Apo AIV amyloidosis were characterized by diffuse interstitial deposition, whereas fibrinogen A a chain amyloidosis showed obliterative glomerular involvement. Compared with other types, Ig amyloidosis was associated with lower serum creatinine, higher degree of proteinuria, and amyloid spicules. Conclusions In the authors' experience, the vast majority of renal amyloidosis cases are Ig derived. The newly identified leukocyte chemotactic factor 2 amyloidosis form was the most common of the rarer causes of renal amyloidosis. With the advent of laser microdissection/mass spectrometry for amyloid typing, the origin of renal amyloidosis can be determined in >97% of cases.

AB - Background and objectives The kidney is the organ most commonly involved in systemic amyloidosis. This study reports the largest clinicopathologic series of renal amyloidosis. Design, setting, participants, & measurements This study provides characteristics of 474 renal amyloidosis cases evaluated at the Mayo Clinic Renal Pathology Laboratory from 2007 to 2011, including age, sex, serum creatinine, proteinuria, type of amyloid, and tissue distribution according to type. Results The type of amyloid was Ig amyloidosis in 407 patients (85.9%), AA amyloidosis in 33 (7.0%), leukocyte chemotactic factor 2 amyloidosis in 13 (2.7%), fibrinogen A a chain amyloidosis in 6 (1.3%), Apo AI, Apo AII, or Apo AIV amyloidosis in 3 (0.6%), combined AA amyloidosis/Ig heavy and light chain amyloidosis in 1 (0.2%), and unclassified in 11 (2.3%). Laser microdissection/mass spectrometry, performed in 147 cases, was needed to determine the origin of amyloid in 74 of the 474 cases (16%), whereas immunofluorescence failed to diagnose 28 of 384 light chain amyloidosis cases (7.3%). Leukocyte chemotactic factor 2 amyloidosis and Apo AI, Apo AII, or Apo AIV amyloidosis were characterized by diffuse interstitial deposition, whereas fibrinogen A a chain amyloidosis showed obliterative glomerular involvement. Compared with other types, Ig amyloidosis was associated with lower serum creatinine, higher degree of proteinuria, and amyloid spicules. Conclusions In the authors' experience, the vast majority of renal amyloidosis cases are Ig derived. The newly identified leukocyte chemotactic factor 2 amyloidosis form was the most common of the rarer causes of renal amyloidosis. With the advent of laser microdissection/mass spectrometry for amyloid typing, the origin of renal amyloidosis can be determined in >97% of cases.

UR - http://www.scopus.com/inward/record.url?scp=84883674592&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883674592&partnerID=8YFLogxK

U2 - 10.2215/CJN.10491012

DO - 10.2215/CJN.10491012

M3 - Article

C2 - 23704299

AN - SCOPUS:84883674592

VL - 8

SP - 1515

EP - 1523

JO - Clinical Journal of the American Society of Nephrology

JF - Clinical Journal of the American Society of Nephrology

SN - 1555-9041

IS - 9

ER -