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KMID : 0882419960510050680
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Korean Journal of Medicine
1996 Volume.51 No. 5 p.680 ~ p.686
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Amyloidosis Associated with Tuberculous Lymphadenopathy
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이현승
유진홍/이상학/윤종구/신제현/권혁상/김양리/신완식/강문원
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Abstract
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We experienced a rare case of amyloidosis associated with tuberculosis.
A 34-year old man was admitted because of multiple lymphadenopathy, intermittent fever, and generalized weakness. He showed massive proteinuria, metabolic acidosis. Low creatinine clearance and hematmesis. The cervical lymph node biopsy revealed
chronic
granuloma with multinucleated giant cell and caseous necrosis consistent with tuberculous lymphadenopathy, and also showed diffuse deposition of homogenous amorphous eosinophilic material. The percutaneous needle biopsy of kidney showed massive
infiltration of pale pinkish amorphous material in the glomerular mesangium. Gastric mucosal biopsy revelaed infiltration of amorphous material in the lamina propria. Polarizing illumination after Congored staining on all the three tissue biopsy
showed
typical green birefringence. A computerized tomographic (CT) scan of the abdomen showed hepatosplenomegaly and both renal vein thrombosis. He was managed with peritoneal dialysis, anti-TBc medication, steroids and other supportive measures.
Despite
aggressive treatment, his condition deterlorated day by day. He was discharged with hopeless condition.
This case indicated that we should not exclude a possibility of the secondary amyloidosis in case of tuberculosis and massive proteinuria.
To our knowledge, we think that this case is the first case of amyloidosis associated with tuberculosis in Korea.
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KEYWORD
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